Incidence of first cardiovascular event in Spanish patients with inflammatory rheumatic diseases: prospective data from the CARMA Project
Por:
Martin-Martinez, MA, Castaneda, S, Gonzalez-Juanatey, C, Sanchez-Alonso, F, Garcia-Gomez, C, Lopez-Gonzalez, R, Babio-Herraiz, J, Juan-Mas, A, Moreno-Gil, MP, Sanchez-Gonzalez, CO, Romera-Baures, M, Pinto-Tasende, JA, Tornero-Molina, J, Fabregas-Canales, D, Llorca, J, Gonzalez-Gay, MA, de Rabago, EG, Morales, EAB, Lopez, JCF, Villar, NO, Sandoval, AA, Garcia, FJB, De Miquel, CA, Fernandez, MJG, Codina, RH, Yoldi, B, Ramentol, M, Avila, G, Barril, SM, Quesada, E, Steiner, M, Munoz, S, Cobo, T, Gamero, F, Toron, JG, Espino, P, Ros, I, Ibanez, M, Murillo, C, Sanmarti, R, Berman, H, Cabrera, S, Ruiz, V, Paton, OF, Gutierrez, BF, Abasolo, L, Pina, JM, Nolla, JM, Arias, MG, Vadillo, JAG, de Vicuna, RG, Nebro, AF, Arija, SM, Lopez, MAB, Urena, I, Irigoyen, MV, Cagigal, VC, Garrido, DP, Aparicio, AMG, Gomez, RB, Bautista, PG, Sanz, AH, Bachiller, J, Manero, FJ, Zorzo, FJ, Ubeda, EG, Garcia, JM, Audera, CB, Medrano, M, Pecondon, A, Erausquin, C, Ojeda, S, Quevedo, JC, Francisco, F, Lozano, CR, Longo, FJL, Gerona, D, Fernandez, CG, Monteagudo, I, del Pino, J, Gonzalez, MDS, Corrales, A, Peiro, ME, Senabre, JM, Rosas, JC, Rotes, I, Moreno, E, Erra, A, Grado, D, Calvo, J, Rueda, A, Moller, I, Rodriguez, I, Barbadillo, C, Raya, E, Morales, P, Nieto, A, Jimenez, I, Magro, C, Escribano, AR, Exposito, SR, Nievas, GS, Navarro, EJ, Fernandez, MS, Morales, MAG, Bastero, IL, Consuegra, GG, Palmou, N, Pardo, SM, Pujol, M, Alonso, ER, Salvador, G, Alvarez, BG, Cantabrana, A, Bustabad, S, Delgado, E, Munoz, A, Montero, SR, Jimenez, LM, Redondo, JR, Hernandez, TG, Polo, FJG, Almagro, RM, Moreno, JM, Serret, EG, Barroso, CL, Mendez, LC, Navio, MT, Carballido, CF, Pagan, E, del Castillo, PM, Naredo, E, Cruz, A, Turrion, A, Sanchez, J, Galindo, M, Gonzalez, JG, Collantes, E, Ruiz, D, Font, P, Bonilla, G, Meseguer, AL, Moreno, MJ, Martinez, MJM, Fernandez, MDB, Linares, LF, Morcillo, M, Gomez, MLG, Rivera, NA, Berrizbeitia, OF, Vivar, MLG, Riera, M, Leon, YM, Maymo, J, Amirall, M, Escolano, SI, Serrano, SS, Bona, MPL, Fiter, J, Melon, JF, Espadaler, L, Maiz, O, Belzunegui, J, Banegil, I, Diaz, C, Valls, R, Castellvi, I, Bonet, M, Ruzafa, EM, Alen, JC, Sandoval, TP, Evrard, ER, Godo, JR, Espartero, CF, Blasco, FJN, Gonzalez, JA, Miranda-Filloy, JA
Publicada:
1 sep 2019
Resumen:
Objective
To determine the incidence and risk factors of first cardiovascular event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD).
Methods
Analysis of data after 2.5 years of follow-up from the prospective study CARMA project, that includes patients with CIRD [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)] and matched individuals without CIRD from 67 hospitals in Spain. CVE cumulative incidence per 1000 patients was calculated after 2.5 years from the start of the project. Weibull proportional hazard model was used to calculate hazard ratio (HR) and 95% confidence interval (95% CI) of the risk factors.
Results
2595 (89.1%) patients completed the 2.5 years of follow-up visit. Cumulative incidence of CVE in patients with CIRD was 15.30 cases per 1000 patients (95% CI: 12.93-17.67), being higher in the subgroup with AS; 22.03 (95% CI: 11.01-33.04). Patients with AS (HR: 4.11; 95% CI: 1.07-15.79), those with older age (HR: 1.09; 95% CI: 1.05-1.13), systolic hypertension (HR: 1.02; 95% CI: 1.00-1.04) and long duration of the disease (HR: 1.07; 95% CI: 1.03-1.12) were at higher risk of first CVE during the 2.5 years of follow-up. In contrast, female gender was a protective factor (HR: 0.43; 95% CI: 0.18-1.00).
Conclusion
Among CIRD patients prospectively followed-up at rheumatology outpatient clinics, those with AS show higher risk of first CVE. Besides cardiovascular risk factors, such as hypertension, being a man and older
Filiaciones:
Martin-Martinez, MA:
Spanish Soc Rheumatol, Res Unit, Madrid, Spain
Castaneda, S:
Hosp Univ Princesa, Div Rheumatol, IIS Princesa, Madrid, Spain
Gonzalez-Juanatey, C:
Hosp Lucus Augusti, Div Cardiol, Lugo, Spain
Sanchez-Alonso, F:
Spanish Soc Rheumatol, Res Unit, Madrid, Spain
Garcia-Gomez, C:
Consorci Sanitari Terrassa, Div Rheumatol, Barcelona, Spain
Lopez-Gonzalez, R:
Hosp Gen de la Virgen Concha, Div Rheumatol, Zamora, Spain
Babio-Herraiz, J:
Hosp Cabuenes, Div Rheumatol, Gijon, Spain
Juan-Mas, A:
Hosp Son Llatzer, Div Rheumatol, Palma de Mallorca, Spain
Moreno-Gil, MP:
Hosp San Pedro de Alcantara, Div Rheumatol, Caceres, Spain
Sanchez-Gonzalez, CO:
Hosp Sureste, Div Rheumatol, Madrid, Spain
Romera-Baures, M:
Bellvitge Hosp, Div Rheumatol, Barcelona, Spain
Pinto-Tasende, JA:
Complejo Hosp A Coruna, Div Rheumatol, Xubias De Arriba, A Coruna, Spain
Tornero-Molina, J:
Hosp Univ Guadalajara, Div Rheumatol, Guadalajara, Spain
Fabregas-Canales, D:
Hosp Barbastro, Div Rheumatol, Huesca, Spain
Llorca, J:
Univ Cantabria, Sch Med, Div Epidemiol & Computat Biol, Santander, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Santander, Spain
Gonzalez-Gay, MA:
Univ Cantabria, Hosp Univ Marques de Valdecilla, Div Rheumatol, Santander, Spain
IDIVAL, Div Rheumatol, Epidemiol Genet & Atherosclerosis Res Grp System, Santander, Spain
Univ Witwatersrand, Cardiovasc Pathophysiol & Genom Res Unit, Fac Hlth Sci, Sch Physiol, Johannesburg, South Africa
de Rabago, EG:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
Morales, EAB:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
Lopez, JCF:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
Villar, NO:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
Sandoval, AA:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
Garcia, FJB:
Complejo Hosp A Coruna, Xubias De Arriba, A Coruna, Spain
De Miquel, CA:
Inst Dexeus, Barcelona, Spain
Fernandez, MJG:
Inst Dexeus, Barcelona, Spain
Codina, RH:
Inst Dexeus, Barcelona, Spain
Yoldi, B:
Inst Dexeus, Barcelona, Spain
Ramentol, M:
Inst Dexeus, Barcelona, Spain
Avila, G:
Hosp Univ Vall dHebron, Barcelona, Spain
Barril, SM:
Hosp Univ Vall dHebron, Barcelona, Spain
Quesada, E:
Hosp Univ Vall dHebron, Barcelona, Spain
Steiner, M:
Hosp Infanta Sofia, Madrid, Spain
Munoz, S:
Hosp Infanta Sofia, Madrid, Spain
Cobo, T:
Hosp Infanta Sofia, Madrid, Spain
Gamero, F:
Hosp S Pedro de Alcantara, Caceres, Spain
Toron, JG:
Hosp S Pedro de Alcantara, Caceres, Spain
Espino, P:
Hosp Son Llatzer, Palma De Mallorca, Spain
Ros, I:
Hosp Son Llatzer, Palma De Mallorca, Spain
Ibanez, M:
Hosp Son Llatzer, Palma De Mallorca, Spain
Murillo, C:
Hosp Son Llatzer, Palma De Mallorca, Spain
Sanmarti, R:
Hosp Clin Barcelona, Barcelona, Spain
Berman, H:
Hosp Clin Barcelona, Barcelona, Spain
Cabrera, S:
Hosp Clin Barcelona, Barcelona, Spain
Ruiz, V:
Hosp Clin Barcelona, Barcelona, Spain
Paton, OF:
Hosp Clin Univ San Carlos, Madrid, Spain
Gutierrez, BF:
Hosp Clin Univ San Carlos, Madrid, Spain
Abasolo, L:
Hosp Clin Univ San Carlos, Madrid, Spain
Nolla, JM:
Hosp Univ Bellvitge, Barcelona, Spain
Arias, MG:
Hosp Univ De La Princesa, Madrid, Spain
Vadillo, JAG:
Hosp Univ De La Princesa, Madrid, Spain
de Vicuna, RG:
Hosp Univ De La Princesa, Madrid, Spain
Nebro, AF:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Arija, SM:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Lopez, MAB:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Urena, I:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Irigoyen, MV:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Cagigal, VC:
Hosp Reg Univ Carlos Haya, Malaga, Spain
Garrido, DP:
Hosp Virgen de la Salud, Toledo, Spain
Aparicio, AMG:
Hosp Virgen de la Salud, Toledo, Spain
Gomez, RB:
Hosp Virgen de la Salud, Toledo, Spain
Bautista, PG:
Hosp Virgen de la Salud, Toledo, Spain
Sanz, AH:
Hosp Virgen de la Salud, Toledo, Spain
Bachiller, J:
Hosp Ramon & Cajal, Madrid, Spain
Manero, FJ:
Hosp Univ Miguel Servet, Zaragoza, Spain
Zorzo, FJ:
Hosp Univ Miguel Servet, Zaragoza, Spain
Ubeda, EG:
Hosp Univ Miguel Servet, Zaragoza, Spain
Garcia, JM:
Hosp Univ Miguel Servet, Zaragoza, Spain
Audera, CB:
Hosp Univ Miguel Servet, Zaragoza, Spain
Medrano, M:
Hosp Univ Miguel Servet, Zaragoza, Spain
Pecondon, A:
Hosp Univ Miguel Servet, Zaragoza, Spain
Erausquin, C:
Hosp Dr Negrin, Las Palmas Gran Canaria, Spain
Ojeda, S:
Hosp Dr Negrin, Las Palmas Gran Canaria, Spain
Quevedo, JC:
Hosp Dr Negrin, Las Palmas Gran Canaria, Spain
Francisco, F:
Hosp Dr Negrin, Las Palmas Gran Canaria, Spain
Lozano, CR:
Hosp Dr Negrin, Las Palmas Gran Canaria, Spain
Longo, FJL:
Hosp Gregorio Maranon, Madrid, Spain
Gerona, D:
Hosp Gregorio Maranon, Madrid, Spain
Fernandez, CG:
Hosp Gregorio Maranon, Madrid, Spain
Monteagudo, I:
Hosp Gregorio Maranon, Madrid, Spain
del Pino, J:
Hosp Univ Salamanca, Salamanca, Spain
Gonzalez, MDS:
Hosp Univ Salamanca, Salamanca, Spain
Corrales, A:
Hosp Univ Marques de Valdecilla, Santander, Spain
Peiro, ME:
Hosp Univ Marques de Valdecilla, Santander, Spain
Senabre, JM:
Hosp Marina Baixa, Alicante, Spain
Rosas, JC:
Hosp Marina Baixa, Alicante, Spain
Rotes, I:
Hosp San Rafael, Barcelona, Spain
Moreno, E:
Hosp San Rafael, Barcelona, Spain
Erra, A:
Hosp San Rafael, Barcelona, Spain
Grado, D:
Hosp San Rafael, Barcelona, Spain
Calvo, J:
Hosp Gen Univ, Valencia, Spain
Rueda, A:
Hosp Gen Univ, Valencia, Spain
Moller, I:
Inst Poal, Barcelona, Spain
Rodriguez, I:
Inst Poal, Barcelona, Spain
Barbadillo, C:
Hosp Univ Puerta Hierro, Madrid, Spain
Raya, E:
Hosp Clin Univ San Cecilio, Granada, Spain
Morales, P:
Hosp Clin Univ San Cecilio, Granada, Spain
Nieto, A:
Hosp Clin Univ San Cecilio, Granada, Spain
Jimenez, I:
Hosp Clin Univ San Cecilio, Granada, Spain
Magro, C:
Hosp Clin Univ San Cecilio, Granada, Spain
Escribano, AR:
Hosp Santiago Apostol, Vitoria, Spain
Exposito, SR:
Hosp Viladecans, Barcelona, Spain
Nievas, GS:
Hosp Gen Albacete, Albacete, Spain
Navarro, EJ:
Hosp Gen Albacete, Albacete, Spain
Fernandez, MS:
Hosp Gen Albacete, Albacete, Spain
Morales, MAG:
Hosp Gen Albacete, Albacete, Spain
Bastero, IL:
Hosp Gen Albacete, Albacete, Spain
Consuegra, GG:
Hosp Gen Albacete, Albacete, Spain
Palmou, N:
Hosp Gen Albacete, Albacete, Spain
Pardo, SM:
Hosp Mutua Terrassa, Terrassa, Spain
Pujol, M:
Hosp Mutua Terrassa, Terrassa, Spain
Alonso, ER:
Hosp Mutua Terrassa, Terrassa, Spain
Salvador, G:
Hosp Mutua Terrassa, Terrassa, Spain
Alvarez, BG:
Hosp Ntra Sra Candelaria, Santa Cruz De Tenerife, Spain
Cantabrana, A:
Hosp Ntra Sra Candelaria, Santa Cruz De Tenerife, Spain
Bustabad, S:
Hosp Univ Canarias, Tenerife, Spain
Delgado, E:
Hosp Univ Canarias, Tenerife, Spain
Munoz, A:
Hosp Univ Valme, Seville, Spain
Montero, SR:
Hosp Univ Valme, Seville, Spain
Jimenez, LM:
Hosp Univ Valme, Seville, Spain
Redondo, JR:
Inst Prov Rehabil, Madrid, Spain
Hosp Basurto, Bilbao, Spain
Hernandez, TG:
Inst Prov Rehabil, Madrid, Spain
Polo, FJG:
Hosp Cantoblanco, Madrid, Spain
Almagro, RM:
Hosp Jerez de la Frontera, Cadiz, Spain
Moreno, JM:
Hosp Obispo Polanco, Teruel, Spain
Serret, EG:
Hosp Obispo Polanco, Teruel, Spain
Barroso, CL:
Hosp Obispo Polanco, Teruel, Spain
Mendez, LC:
Hosp Infanta Leonor, Madrid, Spain
Navio, MT:
Hosp Infanta Leonor, Madrid, Spain
Carballido, CF:
Hosp Gen Elda, Alicante, Spain
Pagan, E:
Hosp Los Arcos, Murcia, Spain
del Castillo, PM:
Hosp Los Arcos, Murcia, Spain
Naredo, E:
Hosp Severo Ochoa, Madrid, Spain
Cruz, A:
Hosp Severo Ochoa, Madrid, Spain
Turrion, A:
Hosp Principe Asturias, Madrid, Spain
Sanchez, J:
Hosp Univ 12 Octubre, Madrid, Spain
Galindo, M:
Hosp Univ 12 Octubre, Madrid, Spain
Gonzalez, JG:
Hosp Univ 12 Octubre, Madrid, Spain
Collantes, E:
Hosp Univ Reina Sofia, Cordoba, Spain
Ruiz, D:
Hosp Univ Reina Sofia, Cordoba, Spain
Font, P:
Hosp Univ Reina Sofia, Cordoba, Spain
Bonilla, G:
Hosp Univ La Paz, Madrid, Spain
Meseguer, AL:
Hosp Gutierrez Ortega, Ciudad Real, Spain
Moreno, MJ:
Hosp Virgen Arrixaca, Murcia, Spain
Martinez, MJM:
Hosp Virgen Arrixaca, Murcia, Spain
Fernandez, MDB:
Hosp Virgen Arrixaca, Murcia, Spain
Linares, LF:
Hosp Virgen Arrixaca, Murcia, Spain
Morcillo, M:
Hosp Escorial, Madrid, Spain
Gomez, MLG:
Hosp Escorial, Madrid, Spain
Berrizbeitia, OF:
Hosp Basurto, Bilbao, Spain
Vivar, MLG:
Hosp Basurto, Bilbao, Spain
Riera, M:
Hosp Dos de Maig, Barcelona, Spain
Leon, YM:
Hosp Dos de Maig, Barcelona, Spain
Maymo, J:
Hosp Mar, Barcelona, Spain
Amirall, M:
Hosp Mar, Barcelona, Spain
Escolano, SI:
Hosp Mar, Barcelona, Spain
Serrano, SS:
Hosp Mar, Barcelona, Spain
Bona, MPL:
Hosp Mar, Barcelona, Spain
Fiter, J:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Melon, JF:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Espadaler, L:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Maiz, O:
Hosp Donostia, Donostia San Sebastian, Spain
Belzunegui, J:
Hosp Donostia, Donostia San Sebastian, Spain
Banegil, I:
Hosp Donostia, Donostia San Sebastian, Spain
Diaz, C:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Valls, R:
Hosp Palamos, Girona, Spain
Castellvi, I:
Hosp Comarcal LAlt Penedes, Barcelona, Spain
Bonet, M:
Hosp Comarcal LAlt Penedes, Barcelona, Spain
Ruzafa, EM:
Hosp Comarcal LAlt Penedes, Barcelona, Spain
Alen, JC:
Hosp Sierrallana, Torrelavega, Spain
Sandoval, TP:
Complejo Asistencial Leon, Leon, Spain
Evrard, ER:
Gen Hosp Ciudad Real, Ciudad Real, Spain
Godo, JR:
Hosp Gen Mostoles, Madrid, Spain
Espartero, CF:
Hosp Gen Mostoles, Madrid, Spain
Blasco, FJN:
Hosp Gen Univ Elche, Alicante, Spain
Gonzalez, JA:
Hosp Gen Univ Elche, Alicante, Spain
Miranda-Filloy, JA:
Hosp Xeral Calde, Lugo, Spain
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