TY - JOUR
T1 - No Increased Occurrence of Ischemic Heart Disease Prior to the Onset of Rheumatoid Arthritis Results From Two Swedish Population-Based Rheumatoid Arthritis Cohorts
AU - Holmqvist, Marie E.
AU - Wedren, Sara
AU - Jacobsson, Lennart
AU - Klareskog, Lars
AU - Nyberg, Fredrik
AU - Rantapaa-Dahlqvist, Solbritt
AU - Alfredsson, Lars
AU - Askling, Johan
PY - 2009
Y1 - 2009
N2 - Objective. To investigate the relative importance of shared etiologies for rheumatoid arthritis (RA) and ischemic heart disease (IHD) in terms of the well-known increased risk of HID in patients with RA, by assessing the occurrence of IHD up until the time of the onset of the first symptoms of RA. Methods. We assessed the prevalence of a history of IHD, myocardial infarction (MI), and angina pectoris before the onset of RA symptoms in 2 large population-based case-control studies. Patients with newly diagnosed RA according to the criteria of the American College of Rheumatology were included as cases. We used data from the Swedish Early Arthritis Register study and the Swedish Epidemiologic Investigation of Rheumatoid Arthritis case-control study and from general population controls. Information on IHD, MI, and angina pectoris was obtained from the nationwide Hospital Discharge Register and from self reports. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) to compare the prevalence of a history of IHD/Mi/angina pectoris among patients with RA with that among population controls. Results. We could not detect any increased occurrence of IHD, MI, or angina pectoris before the onset of symptoms of RA, regardless of whether data on IHD were obtained from the Hospital Discharge Register or were self reported. As detected in the Hospital Discharge Register, the OR for IHD overall was 1.0 (95% CI 0.9-1.1), the OR for MI was 1.0 (95% CI 0.9-1.1), and the OR for angina pectoris was 1.0 (95% CI 0.9-1.2). Conclusion. Shared risk factors or susceptibilities for RA and IHD are likely to contribute less than RA-related factors to the increased occurrence of IHD in patients with manifest RA. Nonetheless, the existence of shared factors associated with longer latency until the occurrence of IHD cannot be excluded.
AB - Objective. To investigate the relative importance of shared etiologies for rheumatoid arthritis (RA) and ischemic heart disease (IHD) in terms of the well-known increased risk of HID in patients with RA, by assessing the occurrence of IHD up until the time of the onset of the first symptoms of RA. Methods. We assessed the prevalence of a history of IHD, myocardial infarction (MI), and angina pectoris before the onset of RA symptoms in 2 large population-based case-control studies. Patients with newly diagnosed RA according to the criteria of the American College of Rheumatology were included as cases. We used data from the Swedish Early Arthritis Register study and the Swedish Epidemiologic Investigation of Rheumatoid Arthritis case-control study and from general population controls. Information on IHD, MI, and angina pectoris was obtained from the nationwide Hospital Discharge Register and from self reports. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) to compare the prevalence of a history of IHD/Mi/angina pectoris among patients with RA with that among population controls. Results. We could not detect any increased occurrence of IHD, MI, or angina pectoris before the onset of symptoms of RA, regardless of whether data on IHD were obtained from the Hospital Discharge Register or were self reported. As detected in the Hospital Discharge Register, the OR for IHD overall was 1.0 (95% CI 0.9-1.1), the OR for MI was 1.0 (95% CI 0.9-1.1), and the OR for angina pectoris was 1.0 (95% CI 0.9-1.2). Conclusion. Shared risk factors or susceptibilities for RA and IHD are likely to contribute less than RA-related factors to the increased occurrence of IHD in patients with manifest RA. Nonetheless, the existence of shared factors associated with longer latency until the occurrence of IHD cannot be excluded.
U2 - 10.1002/art.24855
DO - 10.1002/art.24855
M3 - Article
C2 - 19790058
SN - 1529-0131
VL - 60
SP - 2861
EP - 2869
JO - Arthritis and Rheumatism
JF - Arthritis and Rheumatism
IS - 10
ER -