Autoimmune rheumatic diseases and premature atherosclerotic cardiovascular disease: An analysis from the VITAL registry

Document Type

Article

Department

Cardiology; Office of the Provost

Abstract

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 VITAL registry including patients with premature (males young=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 to age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (OR:1.69, 95% 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.

Comments

This work was published before Salim joined Aga Khan University.

Publication (Name of Journal)

The American Journal of Medicine

DOI

10.1016/j.amjmed.2020.05.026

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