TY - JOUR T1 - Cardiovascular Event Risk in Rheumatoid Arthritis Compared with Type 2 Diabetes: A 15-year Longitudinal Study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.180726 SP - jrheum.180726 AU - Rabia Agca AU - Luuk H.G.A. Hopman AU - Koen J.C. Laan AU - Vokko P. van Halm AU - Mike J.L. Peters AU - Yvo M. Smulders AU - Jacqueline M. Dekker AU - Giel Nijpels AU - Coen D.A. Stehouwer AU - Alexandre E. Voskuyl AU - Maarten Boers AU - Willem F. Lems AU - Michael T. Nurmohamed Y1 - 2019/05/15 UR - http://www.jrheum.org/content/early/2019/11/08/jrheum.180726.abstract N2 - Objective Cardiovascular (CV) disease (CVD) risk is increased in rheumatoid arthritis (RA). However, longterm followup studies investigating this risk are scarce. Methods The CARRÉ (CARdiovascular research and RhEumatoid arthritis) study is a prospective cohort study investigating CVD and its risk factors in 353 patients with longstanding RA. CV endpoints were assessed at baseline and 3, 10, and 15 years after the start of the study and are compared to a reference cohort (n = 2540), including a large number of patients with type 2 diabetes (DM). Results Ninety-five patients with RA developed a CV event over 2973 person-years, resulting in an incidence rate of 3.20 per 100 person-years. Two hundred fifty-seven CV events were reported in the reference cohort during 18,874 person-years, resulting in an incidence rate of 1.36 per 100 person-years. Age- and sex-adjusted HR for CV events were increased for RA (HR 2.07, 95% CI 1.57–2.72, p < 0.01) and DM (HR 1.51, 95% CI 1.02–2.22, p = 0.04) compared to the nondiabetic participants. HR was still increased in RA (HR 1.82, 95% CI 1.32–2.50, p < 0.01) after additional adjustment for CV risk factors. Patients with both RA and DM or insulin resistance had the highest HR for developing CVD (2.21, 95% CI 1.01–4.80, p = 0.046 and 2.67, 95% CI 1.30–5.46, p < 0.01, respectively). Conclusion The incidence rate of CV events in established RA was more than double that of the general population. Patients with RA have an even higher risk of CVD than patients with DM. This risk remained after adjustment for traditional CV risk factors, suggesting that systemic inflammation is an independent contributor to CV risk. ER -