Document Detail

Rapid increase in myocardial infarction risk following diagnosis of rheumatoid arthritis amongst patients diagnosed between 1995 and 2006.
MedLine Citation:
PMID:  20698926     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the risk of MI and other IHD events amongst patients diagnosed with RA during the last decade and within 18 months following RA symptom onset, compared to the general population, by time since RA diagnosis, year of RA diagnosis and by rheumatoid factor (RF) status.
METHODS AND PATIENTS: A Swedish inception cohort of RA (n = 7469) diagnosed between 1995 and 2006 and a matched general population comparator cohort (n = 37,024), was identified and linked to national registers of morbidity and mortality from IHD. Relative risks (RRs) of MI and other IHD events were estimated using Cox regression.
RESULTS: During follow-up, 233 patients with RA and 701 controls developed a first MI, corresponding to an overall RR of MI of 1.6 (95% confidence interval 1.4, 1.9). Increased risks of MI were already detected within 1-4 years following RA diagnosis, as well as in patients diagnosed with RA during the last 5 years, in RF-negative patients and for transmural as well as nontransmural MIs.
CONCLUSIONS: MI risk increases rapidly following RA diagnosis, suggesting the importance of additional mechanisms other than atherosclerosis. The elevated short-term risk is present amongst patients diagnosed in recent years, underscoring the importance of MI prevention from the time of RA diagnosis.
M E Holmqvist; S Wedrén; L T H Jacobsson; L Klareskog; F Nyberg; S Rantapää-Dahlqvist; L Alfredsson; J Askling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  268     ISSN:  1365-2796     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-14     Revised Date:  2011-06-13    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  578-85     Citation Subset:  IM    
Copyright Information:
© 2010 The Association for the Publication of the Journal of Internal Medicine.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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MeSH Terms
Age Distribution
Aged, 80 and over
Arthritis, Rheumatoid / complications*,  epidemiology,  immunology
Epidemiologic Methods
Hospitalization / statistics & numerical data
Middle Aged
Myocardial Infarction / complications*,  epidemiology
Rheumatoid Factor / blood
Sweden / epidemiology
Time Factors
Reg. No./Substance:
9009-79-4/Rheumatoid Factor
Comment In:
J Intern Med. 2010 Dec;268(6):552-4   [PMID:  21054586 ]
Expert Rev Cardiovasc Ther. 2011 Apr;9(4):429-32   [PMID:  21517727 ]

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