TY - JOUR
T1 - Autoimmune Rheumatic Diseases and Premature Atherosclerotic Cardiovascular Disease
T2 - An Analysis From the VITAL Registry
AU - Mahtta, Dhruv
AU - Gupta, Angela
AU - Ramsey, David J.
AU - Rifai, Mahmoud Al
AU - Mehta, Anurag
AU - Krittanawong, Chayakrit
AU - Lee, Michelle T.
AU - Nasir, Khurram
AU - Samad, Zainab
AU - Blumenthal, Roger S.
AU - Jneid, Hani
AU - Ballantyne, Christie M.
AU - Petersen, Laura A.
AU - Virani, Salim S.
N1 - Funding Information:
Funding: This work was supported by a Department of Veterans Affairs Health Services Research & Development Service Investigator Initiated Grant (IIR 16–072), an American Heart Association Beginning Grant-in-Aid (14BGIA20460366), the American Diabetes Association Clinical Science and Epidemiology award (1-14- CE-44), and the Houston VA Health Services Research & Development Center for Innovations grant (CIN13-413). Support for VA/CMS data provided by the Department of Veterans Affairs, VA Health Services Research and Development Service, VA Information Resource Center (Project Numbers SDR 02-237 and 98-004).The opinions expressed reflect those of the authors and not necessarily those of the Department of Veterans Affairs or the US government.
Funding Information:
Funding: This work was supported by a Department of Veterans Affairs Health Services Research & Development Service Investigator Initiated Grant (IIR 16?072), an American Heart Association Beginning Grant-in-Aid (14BGIA20460366), the American Diabetes Association Clinical Science and Epidemiology award (1-14- CE-44), and the Houston VA Health Services Research & Development Center for Innovations grant (CIN13-413). Support for VA/CMS data provided by the Department of Veterans Affairs, VA Health Services Research and Development Service, VA Information Resource Center (Project Numbers SDR 02-237 and 98-004).The opinions expressed reflect those of the authors and not necessarily those of the Department of Veterans Affairs or the US government. Conflicts of Interest: KN reports research support by Katz Academy of Translational Research and serves on the advisory board for Amgen, Esperion, and Novartis. CMB reports grant and research support paid to institution from Akcea, Amgen, Esperion, Novartis, Regeneron, Sanofi-Synthelabo, National Institutes of Health, American Heart Association, and American Diabetes Association and serves as a consultant for Abbott Diagnostics, Akcea, Amarin, Amgen, Arrowhead, Astra Zeneca, Corvidia, Denka Seiken, Esperion, Intercept, Matinas BioPharma Inc, Merck, Novartis, Regeneron, and Sanofi-Synthelabo. SSV reports honorarium from the American College of Cardiology (Associate Editor for Innovations, aacc.org) and serving on the Steering Committee, Patient and Provider Assessment of Lipid Management (PALM registry) at the Duke Clinical Research Institute, with no financial remuneration. DM, AG, DJR, MAR, AM, CK, MTL, ZS, RSB, HJ, LAP report none.
Funding Information:
Conflicts of Interest: KN reports research support by Katz Academy of Translational Research and serves on the advisory board for Amgen, Esperion, and Novartis. CMB reports grant and research support paid to institution from Akcea, Amgen, Esperion, Novartis, Regeneron, Sanofi-Synthelabo, National Institutes of Health, American Heart Association, and American Diabetes Association and serves as a consultant for Abbott Diagnostics, Akcea, Amarin, Amgen, Arrowhead, Astra Zeneca, Corvidia, Denka Seiken, Esperion, Intercept, Matinas BioPharma Inc, Merck, Novartis, Regeneron, and Sanofi-Synthelabo. SSV reports honorarium from the American College of Cardiology (Associate Editor for Innovations, aacc.org) and serving on the Steering Committee, Patient and Provider Assessment of Lipid Management (PALM registry) at the Duke Clinical Research Institute, with no financial remuneration. DM, AG, DJR, MAR, AM, CK, MTL, ZS, RSB, HJ, LAP report none.
Publisher Copyright:
© 2020
PY - 2020/12
Y1 - 2020/12
N2 - Background: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. Methods: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. Results: Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. Conclusion: Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients.
AB - Background: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. Methods: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. Results: Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. Conclusion: Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients.
KW - Ankylosing spondylitis
KW - Autoimmune
KW - Inflammation
KW - Premature atherosclerotic cardiovascular disease
KW - Psoriatic arthritis
KW - Rheumatic disease
KW - Rheumatoid arthritis
KW - Systemic lupus erythematosus
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U2 - 10.1016/j.amjmed.2020.05.026
DO - 10.1016/j.amjmed.2020.05.026
M3 - Article
C2 - 32598903
AN - SCOPUS:85088376083
VL - 133
SP - 1424-1432.e1
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 12
ER -