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Abstract Background/Aims Cardiovascular disease (CVD) is connected to many comorbidities and vascular diseases. Cancer also has certain inflammatory impact on the physiological mechanisms. However, the precise connection between these variables are unknown. In this research, we determined if there was an association between cardiovascular disease and overall mortality and how this connection may be modified by rheumatoid arthritis. Methods The National Health and Nutrition Examination Survey (NHANES) survey was conducted by the National Center for Health Statistics (NCHS) for the six cycles or years of 1999 to 2010 with mortality follow-up through December 31, 2019. This data is published biennially. Our study was conducted on participants with a history of cancer that were aged 40 years or older living in the United States with cardiovascular disease. CVD was determined by a history of stroke, congestive heart failure, coronary heart disease, and myocardial infarction. History of cancer was considered positive if the respondent answered “yes” to the question “Ever told you had cancer or malignancy”. We assessed RA status by using the arthritis question. We determined diabetes by healthcare worker diagnosed recall of the diagnosis of the disease. In this prospective analysis that we performed Complex Samples Cox regression with adjustment for known confounders to determine the relationship of chronic kidney disease and mortality, and if rheumatoid arthritis has an overall relationship in those living with diabetes. Results Among individuals living with cancer and rheumatoid arthritis, percent mortality for males was 58.2% and for females was 61.9%. For overall mortality, crude hazard ratio (HR) for diabetes was 2.13 (95% confidence interval CI, 1.39-3.25 p 0.001). The adjusted HR was elevated, 1.86 (CI 1.17-2.96, p = 0.01), among people with cardiovascular disease who also had rheumatoid arthritis but close to 1.0 (1.36 CI 1.09-1.70, p = 0.01) among individuals with cardiovascular disease who had no rheumatoid arthritis, after adjusting for medical (cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and obesity) and demographic risk factors (gender and age). Similar patterns do not exist in the general population. Conclusion Among individuals has had a history of cancer, not only does cardiovascular disease lead to two times higher overall mortality but also rheumatoid arthritis occurrence impacts the relationship between cardiovascular disease and overall mortality even after controlling for potential medical and demographic confounders. Cardiovascular is the primary cause of death in many high- and middle-income countries in the world. More prevention efforts need to be made in order to prevent CVD and treat rheumatoid arthritis. Disclosure J. Khubchandani: None. S. Banerjee: None. C. Onukogu: None. R. Gonzales-Lagos: None.
Khubchandani et al. (Mon,) studied this question.