Comparison of Incidence of Myocardial Infarction in Patients With Rheumatoid Arthritis and Diabetes Mellitus
Azka Ali1, Akhtar Ali2, Dilpat Kumar3
1Internal Medicine, Mayo Hospital, Lahore, PAK.
Insights
Patients with rheumatoid arthritis (RA) face cardiovascular risks similar to those with diabetes mellitus (DM). RA significantly increases the risk of non-fatal myocardial infarctions compared to controls, highlighting RA as a key cardiovascular risk factor.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- Rheumatoid arthritis (RA) patients exhibit increased cardiovascular disease (CVD) risk, primarily from myocardial infarctions (MI).
- RA patients receive less cardiovascular screening attention than those with diabetes mellitus (DM).
Purpose of the Study:
- To compare the cardiovascular event risk between patients with rheumatoid arthritis and type 2 diabetes mellitus.
- To evaluate the incidence of major adverse cardiovascular events (MACE) in RA and DM patients versus a control group.
Main Methods:
- Prospective study in Pakistan with 750 participants in three groups: RA, type 2 DM, and control (1:1:1 ratio).
- Participants were monitored for 12 months or until a MACE occurred.
- Comparison of fatal and non-fatal myocardial infarctions (MI) between groups.
Main Results:
- Fatal MI rates were comparable between RA (12.66%) and DM (13.48%) groups (p=0.79).
- Non-fatal MI rates were also comparable between RA (3.93%) and DM (4.35%) groups (p=0.82).
- Non-fatal MI was significantly higher in the RA group (12.66%) compared to the control group (5.58%) (p=0.01).
Conclusions:
- Rheumatoid arthritis and type 2 diabetes mellitus confer similar risks for cardiovascular events.
- Rheumatoid arthritis should be recognized as a significant risk factor for cardiovascular events.
- Multidisciplinary management, including cardiology, is crucial for RA patients.
Abstract:
Introduction Patients with rheumatoid arthritis (RA) have a higher risk of cardiovascular diseases (CVDs) when compared to the general population, with most deaths attributed to myocardial infarctions (MI). However, patients with RA do not get the same attention in terms of cardiovascular screening as compared to other diseases, like diabetes mellitus (DM). Therefore, this study aims to compare the risk of CVD among patients with RA and DM. Methods This prospective study was carried out in Pakistan's two tertiary care hospitals. A total of 750 participants were enrolled in three groups with a 1:1:1 ratio; patients with RA, type 2 DM, and the control group. Patients were observed for 12 months or until the development of a major adverse cardiovascular event (MACE), whichever occurred first. Results Both fatal (12.66% vs. 13.48%; p-value: 0.79) and non-fatal (3.93% vs. 4.35%; p-value: 0.82) MI was comparable between both RA and DM group. However, compared to the control group, non-fatal MI (12.66% vs. 5.58%; p-value: 0.01) was significantly higher in the RA group. Conclusion Our study shows that RA and DM have an equal risk of cardiovascular (CV) events. It is important that RA should be considered as a prominent risk factor for CV events. The management of these patients should be multidisciplinary, including cardiologists.
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