Excess risk of hospital admission for cardiovascular disease within the fi rst 7 years

Ann Rheum Dis 2010;69:1660–1664. doi:10.1136/ard.2009.121871 1660 ABSTRACT Objectives Subjects with rheumatoid factor positive infl ammatory polyarthritis (IP) are known to have increased mortality from cardiovascular disease (CVD). A study was undertaken to examine the risk and baseline predictors of admission with CVD in patients with recentonset IP. Methods Subjects are recruited by the Norfolk Arthritis Register if they present to primary or secondary care with ≥2 swollen joints lasting ≥4 weeks. This analysis includes subjects recruited between 1995 and 1999. Baseline data on lifestyle, demographic characteristics, disease and treatment characteristics were collected. CVD admissions were identifi ed through record linkage with the only acute care hospital in the study region. First-episode hospitalisation rates were compared with those of the general population. Poisson regression was used to calculate the relative risk (RR) of admission for patients with IP (overall and for each risk factor). Death certifi cates were obtained from the national death register. Results 800 patients with recent-onset IP were followed for a median of 7.0 years. 64 CVD-related hospitalisations were observed (11.7 per 1000 person-years). Patients with IP were twice as likely (RR=2.0; 95% CI 1.5 to 2.5) to be hospitalised for CVD as the general population. Diffi culty walking at baseline was a signifi cant predictor of CVD admission and baseline non-steroidal antiinfl ammatory drug use was associated with a reduced risk of CVD admission. Conclusions Patients with IP are at increased risk of CVD-related hospitalisation, within 7 years of symptom onset. Informing patients about lifestyle modifi cation may reduce the risk of CVD.