Related Experiment Video
Updated: May 20, 2025
Author Spotlight: Implementation of BIVA for Analyzing Disease Risk Factors in Patients with Low Body Cell Mass
Published on: July 14, 2023
The Frequency of Cardiovascular Diseases in Rheumatoid Arthritis in Brazil: 10-year Cohort Study with DATASUS
Roberto Gamarski1, Fernando Ferreira de Castro1, Jose Antonio Sena do Nascimento1
1Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.
Insights
Cardiovascular events are common in rheumatoid arthritis (RA) patients treated with disease-modifying antirheumatic drugs (DMARDs). Advanced age, comorbidities, and synthetic DMARD use are linked to these outcomes.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Cardiovascular disease is a significant concern in rheumatoid arthritis (RA).
- Previous research focused on biological factors influencing RA cardiovascular outcomes.
- Understanding RA patient cardiovascular event distribution in Brazil's public health system is crucial.
Purpose of the Study:
- To determine the prevalence of cardiovascular events in Brazilian RA patients within the Unified Health System (SUS).
- To identify factors associated with cardiovascular outcomes in this population.
- To analyze treatment patterns, including biological and synthetic disease-modifying antirheumatic drugs (DMARDs).
Main Methods:
- Retrospective cohort study using the DATASUS database.
- Identified RA patients (≥ 18 years) via ICD-10 codes and SUS procedures.
- Categorized patients by DMARDs (biological vs. synthetic) and treatment patterns; assessed socioeconomic status using IFDM.
Main Results:
- 198 cardiovascular outcomes (4.68%) observed among 4,321 RA patients on DMARDs.
- Majority female (80.3%), mean age 54.2 years, predominantly from Southeast Brazil.
- Advanced age, cardiovascular risk factors, and synthetic DMARD use were significantly associated with adverse cardiovascular events.
Conclusions:
- Cardiovascular outcomes represent a common complication in rheumatoid arthritis patients.
- Treatment strategies and patient comorbidities significantly influence cardiovascular event risk.
- Public health initiatives should address cardiovascular risk in RA patients, particularly those on synthetic DMARDs.
Background:
Cardiovascular outcomes in patients with rheumatoid arthritis (RA) have been extensively explored in the literature concerning biological factors.
Objectives:
This nationwide retrospective cohort study aimed to explore the distribution of cardiovascular events in patients with RA in Brazil, assisted by the Unified Health System (SUS), and to identify factors associated with these outcomes.
Methods:
Patients aged ≥ 18 years were identified from the Brazilian Unified Health System Database (DATASUS) through RA ICD-10 codes and their therapeutic procedures according to SUS guidelines. RA patients treated with disease-modifying antirheumatic drugs (DMARDs) were categorized as biological users and non-biological (synthetic) users. Cardiovascular outcomes, including acute coronary artery disease (ACAD), heart failure, and cerebrovascular accident (CVA), were analyzed. Patients were also categorized based on treatment patterns (switch or constant users). Socioeconomic status was assessed using the FIRJAN Municipal Development Index (IFDM). Descriptive analyses identified population distribution and cardiovascular outcomes, and multiple logistic regression explored associated factors. The statistical significance adopted was p < 0.05.
Results:
Among the 4,321 patients with RA treated with DMARDS, 198 cardiovascular outcomes (4.68%) were identified. The majority were female (3,398 [80.3%]) with a mean age of 54.2 (standard deviation 12.8) years, predominantly from the Southeast Region (2,421 [57.2%]). The predominant overall IFDM was > 0.8 (47.5%). Advanced age, the presence of cardiovascular risk factors, and the use of synthetic DMARDs were associated with cardiovascular outcomes.
Conclusion:
Cardiovascular outcomes in patients with RA are common and are associated with age, comorbidities, and the drugs used for treatment.
Related Concept Videos
01:11Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:23Assessment of blood pressure in brachial artery(two-step method)
01:29Bias in Epidemiological Studies