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Association between chronic immune-mediated inflammatory diseases and cardiovascular risk

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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


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