Related Experiment Video
Updated: Sep 22, 2025
A Calcium Phosphate-Induced Mouse Abdominal Aortic Aneurysm Model
Published on: November 18, 2022
Risk of cardiovascular events in patients having had acute calcium pyrophosphate crystal arthritis
Sara K Tedeschi1,2, Weixing Huang3, Kazuki Yoshida3
1Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA stedeschi1@bwh.harvard.edu.
Insights
Patients with acute calcium pyrophosphate deposition (CPPD) crystal arthritis face higher risks of non-fatal cardiovascular events. This risk is elevated both shortly after diagnosis and in the long term, highlighting a significant association for cardiovascular health.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Calcium pyrophosphate deposition (CPPD) disease is broadly linked to increased cardiovascular (CV) event risk.
- Acute CPP crystal arthritis represents the acute manifestation of CPPD.
Purpose of the Study:
- To investigate the risk of cardiovascular events in patients diagnosed with acute CPP crystal arthritis.
- To compare the incidence of major adverse cardiovascular events (MACE) between patients with acute CPP crystal arthritis and matched comparators.
Main Methods:
- A cohort study utilized electronic health record (EHR) data from Mass General Brigham (1991-2017).
- Patients with acute CPP crystal arthritis were identified using a machine learning algorithm.
- Major adverse cardiovascular event (MACE) included non-fatal CV events (myocardial infarction, acute coronary syndrome, coronary revascularization, stroke) and death. Incidence rates and adjusted hazard ratios were estimated for years 0-2 and 2-10 post-diagnosis.
Main Results:
- 1200 patients with acute CPP crystal arthritis were matched with 3810 comparators.
- The incidence rate for MACE was higher in the first 0-2 years for the acute CPP crystal arthritis group (91/1000 person-years) compared to comparators (59/1000 person-years).
- Acute CPP crystal arthritis was significantly associated with increased risk for MACE in years 0-2 (HR 1.32) and non-fatal CV events in both years 0-2 (HR 1.92) and years 2-10 (HR 2.18).
Conclusions:
- Acute CPP crystal arthritis is significantly associated with an elevated risk of non-fatal cardiovascular events.
- This increased risk is evident in both the short-term (0-2 years) and long-term (2-10 years) following diagnosis.
Objectives:
Calcium pyrophosphate deposition (CPPD) disease, broadly defined, has been associated with increased risk of cardiovascular (CV) events. We investigated risk of CV events in patients with acute CPP crystal arthritis, the acute manifestation of CPPD.
Methods:
Cohort study using Mass General Brigham electronic health record (EHR) data, 1991-2017. Patients with acute CPP crystal arthritis were identified using a published machine learning algorithm with positive predictive value 81%. Comparators were matched on year of EHR entry and index date of patients with acute CPP crystal arthritis (first positive synovial fluid CPP result or mention of 'pseudogout', or matched encounter). Major adverse cardiovascular event (MACE) was a composite of non-fatal CV event (myocardial infarction, acute coronary syndrome, coronary revascularisation, stroke) and death. We estimated incidence rates (IRs) and adjusted hazard ratios for MACE, non-fatal CV event and death, allowing for differential estimates during years 0-2 and 2-10. Sensitivity analyses included: (1) patients with acute CPP crystal arthritis diagnosed during outpatient visits, (2) patients with linked Medicare data, 2007-2016 and (3)patients matched on number of CV risk factors.
Results:
We matched 1200 acute CPP crystal arthritis patients to 3810 comparators. IR for MACE in years 0-2 was 91/1000 person-years (p-y) in acute CPP crystal arthritis and 59/1000 p-y in comparators. In years 2-10, IR for MACE was 58/1000 p-y in acute CPP crystal arthritis and 53/1000 p-y in comparators. Acute CPP crystal arthritis was significantly associated with increased risk for MACE in years 0-2 (HR 1.32, 95% CI 1.01 to 1.73) and non-fatal CV event in years 0-2 (HR 1.92, 95% CI 1.12 to 3.28) and years 2-10 (HR 2.18, 95% CI 1.27 to 3.75), but not death. Results of sensitivity analyses were similar to the primary analysis; in the outpatient-only analysis, risk of non-fatal CVE was significantly elevated in years 2-10 but not in years 0-2.
Conclusions:
Acute CPP crystal arthritis was significantly associated with elevated short and long-term risk for non-fatal CV event.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:24Chronic Kidney Disease II: Clinical Manifestations
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:30Urinary Tract Calculi III: Medical Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...