Background/Purpose: To compare the risk of cardiovascular disease (CVD) and mortality in patients with rheumatoid arthritis (RA), diabetes mellitus (DM), and the general population.

Methods: Patients diagnosed with RA were matched 1:5 by age, sex, and year of RA diagnosis with the general population. In the same period, patients with incident DM were included. Outcomes were heart failure (HF), myocardial infarction (MI), coronary revascularization, and death up to 10 years after diagnosis.

Results:

We included 15,491 patients with RA, 309,698 patients with DM, and 77,455 persons from the general population. Patients with RA had an increased risk of HF (HR 1.46, 95% CI 1.34-1.59), MI (HR 1.48, 95% CI 1.34-1.63), percutaneous coronary intervention (PCI) (HR 1.37, 95% CI 1.22-1.54), and coronary artery bypass grafting (CABG) (HR 1.20, 95% CI 0.98-1.49) compared to the general population. When comparing RA and DM, RA patients had a lower adjusted risk of HF (HR 0.79, 95% CI 0.73-0.85) and CABG (HR 0.61, 95% CI 0.50-0.74) and similar risk of MI and PCI. The mortality risk among patients with RA and the general population was similar, but lower than in patients with DM (RA vs DM: HR 0.65, 95% CI 0.63-0.68).

Conclusion: This study demonstrates that RA is associated with an increased risk of CVD compared to the general population but without reaching the risk levels observed in patients with DM. Among patients with RA, we observed comparable mortality at 10-year follow-up compared to the general population and significantly lower mortality than patients with DM.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/is-cardiovascular-risk-and-mortality-in-rheumatoid-arthritis-compared-to-diabetes-mellitus-and-the-general-population-overestimated/