Disease remission associated with 80% reduction in cardiovascular outcomes

Remission in patients with rheumatoid arthritis (RA) is associated with an 80 per cent reduction in risk of cardiovascular outcomes, the results of a study presented at EULAR 2019 show.

“The heightened risk of cardiovascular disease in patients with rheumatoid arthritis is in large part a consequence of uncontrolled inflammation. By demonstrating that remission of rheumatoid arthritis is associated with a reduction in cardiovascular complications, these results really emphasise the importance of more effective control of disease, beyond symptom management alone,” said Prof John D Isaacs, Chairperson of the Abstract Selection Committee, EULAR.

The study analysed data from 797 patients with RA over three years and found that patients in remission had an 80 per cent reduced risk of clinical cardiovascular disease, defined as heart attack, congestive heart failure, or stroke (odds ratio (OR): 0.20, 95% CI: 0.09-0.95, p=0.041). The authors also demonstrated a 75 per cent reduced risk of pre-clinical cardiovascular disease in patients in remission, defined as lesions on arteries detected by ultrasound (OR: 0.25, 95% CI: 0.11-0.56, p=0.001).

The study also looked at traditional cardiovascular risk factors and the analysis identified type 2 diabetes as being significantly associated with both cardiovascular outcomes, clinical (OR: 6.21, 95% CI: 2.19-17.71, p=0.001) and pre-clinical cardiovascular disease (OR: 4.50, 95% CI: 1.74-11.62, p=0.002). In addition, pre-clinical cardiovascular disease was significantly associated with high blood pressure (OR: 2.03, 95% CI: 1.04-4.14, p=0.042), ACPA (OR: 2.36, 95% CI: 1.19-4.69, p=0.002) and mean values of CRP during follow-up (OR: 1.07, 95% CI: 1.03-1.14, p=0.040).