Factors associated with secondary coronary artery disease in rheumatoid arthritis patients: A systematic review and...

Area of Science:

• Rheumatology
• Cardiology
• Epidemiology

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory condition.
• RA patients exhibit an increased risk of developing cardiovascular diseases, particularly coronary artery disease (CAD).
• Understanding the specific factors contributing to secondary CAD in RA is crucial for risk stratification and management.

Purpose of the Study:

• To systematically review and meta-analyze the factors associated with coronary artery disease (CAD) development in patients with rheumatoid arthritis (RA).
• To identify modifiable and non-modifiable risk factors for secondary CAD in the RA population.

Main Methods:

• A systematic literature search was conducted across multiple databases including PubMed, Embase, and Web of Science.
• Study quality was assessed using the Newcastle-Ottawa Scale.
• Meta-analysis was performed using Stata16 to calculate odds ratios, risk ratios, and hazard ratios with 95% confidence intervals.

Main Results:

• Twenty-nine studies involving RA patients (average age 50.5-81 years, 44.4%-92% women) were included.
• Key factors associated with increased CAD risk in RA patients included older age, male gender, smoking, glucocorticoid use, higher Health Assessment Questionnaire scores, hyperlipidemia, hypertension, diabetes, and elevated C-reactive protein levels.
• These findings highlight a complex interplay of inflammatory, lifestyle, and comorbidity factors.

Conclusions:

• Several factors significantly influence the risk of secondary CAD in RA patients.
• Interventions such as smoking cessation, regular exercise, and appropriate medication management may reduce CAD risk.
• Further investigation is required to understand the impact of age, RA disease severity, and specific medication subgroups on CAD risk stratification in RA.