Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis

Hall, Andrew J.; Stubbs, Brendon; Mamas, Mamas A.; Myint, Phyo Kyaw; Smith, Toby

doi:10.1177/2047487315610663

Cited by 157 publications

(147 citation statements)

References 44 publications

(43 reference statements)

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…8,39,43 In the PRO.V.A. study, people with OA reported a higher presence of frailty, cardiovascular and metabolic diseases than those without.…”

Section: Discussionmentioning

confidence: 99%

“…People with OA are known to have high levels of CVD 8,47 , an increased inflammatory profile 9 and low levels of physical activity 48 , all of which may predispose people with OA to premature mortality due to CVD. Moreover, they use a higher proportion of analgesic medications with an unfavorable CVD profile.…”

Section: Discussionmentioning

confidence: 99%

“…6 CVD are a leading cause of global mortality, with recent estimates demonstrating that CVD account for 17.3 million deaths globally. 7 A recent meta-analysis demonstrated that people with OA are at increased risk of CVDs, 8 which may also be influenced by an elevated chronic inflammatory status in some subgroups with OA. 9 Death due to CVD is potentially preventable through appropriate timely pharmacological and non-pharmacological interventions 10 Therefore, to identify people at higher risk of CVD mortality could be of considerable public health importance.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Veronese

Cereda

Maggi

et al. 2016

Seminars in Arthritis and Rheumatism

Self Cite

140

102

View full text Add to dashboard Cite

Objectives: Osteoarthritis (OA) is a leading cause of disability, but the relationship with premature mortality remains uncertain. We aimed to investigate the relationship between OA and mortality from any cause and from cardiovascular disease (CVD).Methods: Electronic literature databases searches were conducted to identify prospective studies comparing mortality in a sample of people with and without OA.Risk of call-cause and CVD-mortality were summarized using adjusted hazard ratios (HRs) for joint-specific (hand, hip and knee) and joint non-specific OA. New data from the Progetto Veneto Anziani (PRO.V.A.) study were also included.Results: From the PRO.V.A. study (N=2,927), there was no significant increase in CVD mortality risk for participants with any-joint OA (N=1,858) compared to non-OA (all-cause, HR=0.95; 95% CI: 0.77-1.15; CVD, HR=1.12; 95% CI: 0.82-1.54).On meta-analysis, seven studies (OA: 10,018/non-OA: 18,541), with a median 12-year follow-up, reported no increased risk of any-cause mortality in those with OA (HR=1.10; 95% CI: 0.97-1.25). After removing data on hand OA, a significant association between OA and mortality was observed (HR=1.18; 95% CI: 1.08-1.28).There was a significant higher risk of overall mortality for (1) studies conducted in Europe, (2) patients with multi-joint OA; and (3) a radiological diagnosis of OA. OA was associated with significantly higher CVD mortality (HR=1.21; 95% CI: 1.10-1.34). CVD is potentially preventable through appropriate timely pharmacological and non-pharmacological interventions 10 Therefore, to identify people at higher risk of CVD mortality could be of considerable public health importance.Within the past decade, a number of observational studies have reported that people with OA are at increased risk of premature mortality compared to the general population. [11][12][13] However, this evidence is heterogeneous and limited by the lack of adjustment for appropriate confounders.Given this, the purpose of this study was to: i) analyze data from a prospective cohort study on the risk of CVD mortality in OA compared to a non-osteoarthritis cohort, adjusting for important medical morbidities and other confounders; ii) to systematically review the available literature and perform a meta-analysis to 7 determine whether people with OA present a differential risk of overall and CVD mortality than those without OA. We hypothesized that people with OA had a significant higher risk of overall and CVD death compared to those without OA. 8 MATERIALS AND METHODS Prospective cohort study Overall cohortPreviously unpublished data from the Progetto Veneto Anziani (PRO.V.A. study)were used to investigate the risk of overall and CVD mortality in people with OA over a mean follow-up of 4.4 years. The Pro.V.A. study is an observational cohort study on the Italian population aged over 65 years. The study population initially included 3,099 older Caucasian adults (1,245 men/1,854 women), who were randomly selected between 1995 and 1997 using a multistage stratified met...

show abstract

“…8,39,43 In the PRO.V.A. study, people with OA reported a higher presence of frailty, cardiovascular and metabolic diseases than those without.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Veronese

Cereda

Maggi

et al. 2016

Seminars in Arthritis and Rheumatism

Self Cite

140

102

View full text Add to dashboard Cite

show abstract

“…On the basis of substantive knowledge and confirmation by a search of the literature, [23][24][25][26] we identified risk factors for the outcome and potential confounders, which formed a set of candidate covariates to include in multivariable regression analysis. Using a simplified causal graph, 27 we mapped relations between variables, 28 including the special case of time dependent confounders that are mediating intermediates on the causal pathway between NSAID exposure and the acute myocardial infarction outcome (see fig 1 in web appendix 2).…”

Section: Nsaid Exposure and Confoundersmentioning

confidence: 99%

Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data

Bally

Dendukuri

Rich

et al. 2017

BMJ

382

273

View full text Add to dashboard Cite

Objective To characterise the determinants, time course, and risks of acute myocardial infarction associated with use of oral non-steroidal anti-inflammatory drugs (NSAIDs). Design Systematic review followed by a one stage bayesian individual patient data meta-analysis. Data sources Studies from Canadian and European healthcare databases. Review methods Eligible studies were sourced from computerised drug prescription or medical databases, conducted in the general or an elderly population, documented acute myocardial infarction as specific outcome, studied selective cyclo-oxygenase-2 inhibitors (including rofecoxib) and traditional NSAIDs, compared risk of acute myocardial infarction in NSAID users with non-users, allowed for time dependent analyses, and minimised effects of confounding and misclassification bias. Exposure and outcomes Drug exposure was modelled as an indicator variable incorporating the specific NSAID, its recency, duration of use, and dose. The outcome measures were the summary adjusted odds ratios of first acute myocardial infarction after study entry for each category of NSAID use at index date (date of acute myocardial infarction for cases, matched date for controls) versus non-use in the preceding year and the posterior probability of acute myocardial infarction. Results A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations. Conclusions All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.

show abstract

“…Several systematic reviews have examined whether individual types of arthritis (rheumatoid arthritis (RA),7 ankylosing spondylitis (AS),8 psoriatic arthritis (PsA),9 gout10 and osteoarthritis (OA)11) are independently associated with various cardiovascular (CV) outcomes, with the strongest most consistent evidence pointing towards relationships between RA and myocardial infarction (MI) 7. Previous reviews however included studies with variable study populations, sources for controls, designs, outcomes and definitions and had minimal study inclusion criteria for control of confounding.…”

mentioning

confidence: 99%

Incident myocardial infarction associated with major types of arthritis in the general population: a systematic review and meta-analysis

Tosevski²,

et al. 2017

View full text Add to dashboard Cite

show abstract

Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis

Abstract: Background: To examine for a possible relationship between osteoarthritis and cardiovascular

Cited by 157 publications

References 44 publications

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data

Incident myocardial infarction associated with major types of arthritis in the general population: a systematic review and meta-analysis

Contact Info

Product

Resources

About