Crowson CS, et al. - The physicians undertook this study to explore the impact of cardiovascular disease (CVD) risk factors, including potential sex differences, and rheumatoid arthritis (RA)-specific variables on CVD outcome in patients with RA. In these patients, 30% of CVD events were attributable to RA characteristics. These outcomes highlighted that RA characteristics play an important role in efforts to reduce CVD risk among patients with RA.

Methods

•  In 13 rheumatology centres, data on CVD risk factors and RA characteristics were accumulated at baseline.
• With standardised definitions, CVD outcomes (myocardial infarction, angina, revascularisation, stroke, peripheral vascular disease and CVD death) were gathered.

Results

• This study enrolled 5638 patients with RA and no prior CVD (mean age: 55.3 (SD: 14.0) years, 76% women).
• During mean follow-up of 5.8 (SD: 4.4) years, 148 men and 241 women developed a CVD event (10-year cumulative incidence 20.9% and 11.1%, respectively). 
• Findings displayed that men had a higher burden of CVD risk factors, including increased blood pressure, higher total cholesterol and smoking prevalence than women (all p<0.001).
• Among the traditional CVD risk factors, smoking and hypertension had the highest population attributable risk (PAR) overall and among both sexes, followed by total cholesterol.
• The PAR for Disease Activity Score and for seropositivity were comparable in magnitude to the PAR for lipids. 
• A total of 70% of CVD events were attributable to all CVD risk factors and RA characteristics combined (separately 49% CVD risk factors and 30% RA characteristics).