Association between chronic immune-mediated inflammatory diseases and cardiovascular risk

Baena Díez, Jose M.; Garcia Gil, Maria; Comas Cufí, Marc; Ramos, Rafel; Prieto-Alhambra, Daniel; Salvador-González, Betlem; Elosua Llanos, Roberto; Dégano, Irene R.; Peñafiel Muñoz, Judith; Grau Magaña, Maria

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dc.contributor.author	Baena Díez, Jose M.
dc.contributor.author	Garcia Gil, Maria
dc.contributor.author	Comas Cufí, Marc
dc.contributor.author	Ramos, Rafel
dc.contributor.author	Prieto-Alhambra, Daniel
dc.contributor.author	Salvador-González, Betlem
dc.contributor.author	Elosua Llanos, Roberto
dc.contributor.author	Dégano, Irene R.
dc.contributor.author	Peñafiel Muñoz, Judith
dc.contributor.author	Grau Magaña, Maria
dc.date.accessioned	2018-06-04T07:42:23Z
dc.date.available	2018-06-04T07:42:23Z
dc.date.issued	2017
dc.identifier.citation	Baena-Díez JM, Garcia-Gil M, Comas-Cufí M, Ramos R, Prieto-Alhambra D, Salvador-González B. et al. Association between chronic immune-mediated inflammatory diseases and cardiovascular risk. Heart. 2018 Jan;104(2):119-126. DOI: 10.1136/heartjnl-2017-311279
dc.identifier.issn	1355-6037
dc.identifier.uri	http://hdl.handle.net/10230/34791
dc.description.sponsorship	OBJECTIVE: To examine the association between chronic immune-mediated diseases (rheumatoid arthritis, systemic lupus erythematosus or the following chronic immune-mediated inflammatory diagnoses groups: inflammatory bowel diseases, inflammatory polyarthropathies, systemic connective tissue disorders and spondylopathies) and the 6-year coronary artery disease, stroke, cardiovascular disease incidence and overall mortality; and to estimate the population attributable fractions for all four end-points for each chronic immune-mediated inflammatory disease. METHODS: Cohort study of individuals aged 35-85 years, with no history of cardiovascular disease from Catalonia (Spain). The coded diagnoses of chronic immune-mediated diseases and cardiovascular diseases were ascertained and registered using validated codes, and date of death was obtained from administrative data. Cox regression models for each outcome according to exposure were fitted to estimate HRs in two models 1 : after adjustment for sex, age, cardiovascular risk factors and 2 further adjusted for drug use. Population attributable fractions were estimated for each exposure. RESULTS: Data were collected from 991 546 participants. The risk of cardiovascular disease was increased in systemic connective tissue disorders (model 1: HR=1.38 (95% CI 1.21 to 1.57) and model 2: HR=1.31 (95% CI 1.15 to 1.49)), rheumatoid arthritis (HR=1.43 (95% CI 1.26 to 1.62) and HR=1.31 (95% CI 1.15 to 1.49)) and inflammatory bowel diseases (HR=1.18 (95% CI 1.06 to 1.32) and HR=1.12 (95% CI 1.01 to 1.25)). The effect of anti-inflammatory treatment was significant in all instances (HR=1.50 (95% CI 1.24 to 1.81); HR=1.47 (95% CI 1.23 to 1.75); HR=1.43 (95% CI 1.19 to 1.73), respectively). The population attributable fractions for all three disorders were 13.4%, 15.7% and 10.7%, respectively. CONCLUSION: Systemic connective tissue disorders and rheumatoid arthritis conferred the highest cardiovascular risk and population impact, followed by inflammatory bowel diseases.
dc.format.mimetype	application/pdf
dc.language.iso	eng
dc.publisher	BMJ Publishing Group
dc.relation.ispartof	Heart. 2018 Jan;104(2):119-26
dc.rights	© BMJ Publishing Group. http://heart.bmj.com/content/104/2/119.long
dc.subject.other	Artritis
dc.subject.other	Sistema cardiovascular -- Malalties
dc.title	Association between chronic immune-mediated inflammatory diseases and cardiovascular risk
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	http://dx.doi.org/10.1136/heartjnl-2017-311279
dc.subject.keyword	Arthritis
dc.subject.keyword	Cardiovascular disease
dc.subject.keyword	Connective Tissue Diseases
dc.subject.keyword	Inflammation
dc.subject.keyword	Inflammatory Bowel Diseases
dc.subject.keyword	Spondyloarthritis
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.type.version	info:eu-repo/semantics/acceptedVersion