SAN DIEGO — Rheumatoid arthritis patients have a high rate of ischemic heart disease and high associated mortality, even compared with their siblings, Dr. Namita Kumar said at the annual meeting of the American College of Rheumatology.
The data from a review of death certificates clearly suggest that the increased coronary artery disease death risk seen among rheumatoid arthritis patients, compared with their unaffected siblings, is not due to genetics or upbringing but, rather, to the disease or its treatment, Dr. Kumar noted.
The investigators reviewed certificates from a cohort of rheumatoid arthritis patients and their same-sex, arthritis-free siblings who were involved in a study from 1980 to 1992. They found that during the study period the patients with rheumatoid arthritis were almost twice as likely as their siblings to die. The most common cause of death listed among participants with rheumatoid arthritis was coronary artery disease; in contrast, the most common cause of death for their siblings was malignancy. Fifty-four percent of the 257 rheumatoid arthritis patients died during the period, compared with 28% of the 371 same-sex siblings.
The age of death was not dissimilar (72 years versus 73 years). But the three major causes of death in the rheumatoid arthritis patients were coronary artery disease (35%), all-cause infection (34%), and malignancy (19%). The major causes of death in the siblings were malignancy (38%), all-cause infection (25%), and coronary artery disease (22%).
A similar percentage of patients and their siblings died from stroke (8% versus 10%), noted Dr. Kumar of Freeman Hospital, Newcastle upon Tyne, England.
Genetics, family history, and the environment do not account for the prevalence of ischemic heart disease in rheumatoid arthritis [patients], she said.