What question did this study set out to answer?

To quantify the excess cardiovascular mortality associated with rheumatoid arthritis and determine whether this risk has decreased over the past 50 years.

August 20, 2009Lara D. VeekenOpen Access

Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies

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Why the study?

Does rheumatoid arthritis increase the risk of cardiovascular mortality compared with the general population, and has this risk decreased over time?

Population

91,916 patients with rheumatoid arthritis from 17 cohort studies

Comparison

Rheumatoid arthritis (disease state) vs General population

Design

Meta-analysis

Follow-up

over 50 years (mid-cohort years 1945 to 1995)

Authors

CMChristophe MeuneHeart Failure / Cardiomyopathy ETEmmanuel TouzéUniversité Claude Bernard Lyon 1 LTLudovic TrinquartPreventive Cardiology

Discussion

Member takes

Implication

Sustained CV risk vigilance remains essential in RA; confirms unchanging excess mortality and challenges assumptions of improvement with modern therapies.

Key Points

To quantify the excess cardiovascular mortality associated with rheumatoid arthritis and determine whether this risk has decreased over the past 50 years.
Conducted a systematic review and meta-analysis of cohort studies in MEDLINE and EMBASE from January 1960 to November 2008.
Analyzed 17 cohort studies comprising 91,916 patients, calculating pooled standardized mortality ratios (SMRs) and evaluating temporal trends via meta-regression.
Rheumatoid arthritis was associated with an overall pooled standardized mortality ratio (SMR) for cardiovascular death of 1.6 (95% CI: 1.5–1.8; I² = 93%, P < 0.0001).
Meta-regression across mid-cohort years ranging from 1945 to 1995 demonstrated no significant decline in cardiovascular mortality over time (P = 0.784) and no association with disease duration at inclusion (P = 0.513).

Structured PICO

Does rheumatoid arthritis increase the risk of cardiovascular mortality compared with the general population, and has this risk decreased over time?

Population

91,916 patients with rheumatoid arthritis from 17 cohort studies

Intervention

Rheumatoid arthritis (disease state)

Comparator

General population

Outcome

Cardiovascular mortalityhard clinical

Rheumatoid arthritis is associated with a 60% increased risk of cardiovascular death compared to the general population, a risk that has remained unchanged over the past 50 years.

Cite This Study

Meune et al. (2009) studied this question.

synapsesocial.com/papers/6a709e4b31a3df824328e07c https://doi.org/10.1093/rheumatology/kep252

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Implication

Sustained CV risk vigilance remains essential in RA; confirms unchanging excess mortality and challenges assumptions of improvement with modern therapies.

Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider