TY - JOUR
T1 - Autoimmune Rheumatic Diseases and Premature Atherosclerotic Cardiovascular Disease
T2 - An Analysis From the VITAL Registry
AU - Mahtta, Dhruv
AU - Gupta, Angela
AU - Ramsey, David J.
AU - Rifai, Mahmoud Al
AU - Mehta, Anurag
AU - Krittanawong, Chayakrit
AU - Lee, Michelle T.
AU - Nasir, Khurram
AU - Samad, Zainab
AU - Blumenthal, Roger S.
AU - Jneid, Hani
AU - Ballantyne, Christie M.
AU - Petersen, Laura A.
AU - Virani, Salim S.
N1 - Publisher Copyright:
© 2020
PY - 2020/12
Y1 - 2020/12
N2 - Background: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. Methods: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. Results: Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. Conclusion: Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients.
AB - Background: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. Methods: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. Results: Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. Conclusion: Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients.
KW - Ankylosing spondylitis
KW - Autoimmune
KW - Inflammation
KW - Premature atherosclerotic cardiovascular disease
KW - Psoriatic arthritis
KW - Rheumatic disease
KW - Rheumatoid arthritis
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=85088376083&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2020.05.026
DO - 10.1016/j.amjmed.2020.05.026
M3 - Article
C2 - 32598903
AN - SCOPUS:85088376083
SN - 0002-9343
VL - 133
SP - 1424-1432.e1
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 12
ER -
