Trends of Cardiac Complications in Patients With Rheumatoid Arthritis: Analysis of the United States National Inpatient Sample; 2005-2014

Bandyopadhyay, Dhrubajyoti; Banerjee, Upasana; Hajra, Adrija; Chakraborty, Sandipan; Amgai, Birendra; Ghosh, Raktim; Haddadin, Faris; Modi, Vivek; Sinha, Kalyan B.; Aronow, Wilbert S.; Deedwania, Prakash; Lavie, Carl J.

doi:10.1016/j.cpcardiol.2019.100455

Cited by 19 publications

(11 citation statements)

References 48 publications

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“…This decrease is also consistent with other trends with decreasing hospitalizations for MI (24‐26) noted nationwide; hence, it is unclear whether the treatment of RA has had a significant impact on MI hospitalizations. Bandhopadhyay et al (27) also studied trends in MI among RA hospitalizations. Our conclusions differ from their results (increasing trend of MI among patients with RA).…”

Section: Discussionmentioning

confidence: 99%

Trends in Hospitalization Rates, Major Causes of Hospitalization, and In‐Hospital Mortality in Rheumatoid Arthritis in the United States From 2000 to 2014

Gao

Field

Curtis

et al. 2020

ACR Open Rheumatology

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Objective. To evaluate national trends in hospitalizations and in-hospital mortality in rheumatoid arthritis (RA). Methods. National Inpatient Sample from 2000-2014 and United States Census data were used to study temporal trends in adult RA hospitalizations, reasons for hospitalizations, and in-hospital mortality. Results. The data represented 183 983 hospitalizations with a primary diagnosis of RA. The annual rates of hospitalization for the primary diagnosis of RA decreased from 76.54 admissions per 1 million in 2000 to 29.96 per 1 million in 2014 (P trend < 0.0001). The hospital mortality rate declined from 0.70% to 0.41% (P trend < 0.0001) in this group. With a primary or nonprimary diagnosis of RA, the mortality rate ranged between 1.95 and 2.87 (P trend 0.08). For a nonprimary diagnosis of RA, we noted that the proportion of hospitalizations with a diagnosis of myocardial infarction (6.4% in 2000 to 4.6% in 2014; P < 0.001) significantly decreased, but the absolute number of hospitalizations significantly increased. In contrast, the proportion and the absolute number of hospitalizations with any diagnosis of sepsis, congestive heart failure, lung disease, and urinary tract infection increased significantly. We also noted a significant increase in the actual rate and proportions for hospitalizations for hip and knee arthroplasty. Among in-hospital deaths when RA was a nonprimary diagnosis, the most common primary diagnosis was pneumonia (12.5 %) in 2000, whereas sepsis accounted for the most deaths in 2014 (31.4%). Conclusion. We observed that hospitalization rates and in-hospital mortality rates in patients with RA have changed significantly over the past 15 years.

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Section: Discussionmentioning

confidence: 99%

Trends in Hospitalization Rates, Major Causes of Hospitalization, and In‐Hospital Mortality in Rheumatoid Arthritis in the United States From 2000 to 2014

Gao

Field

Curtis

et al. 2020

ACR Open Rheumatology

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“…However, the mortality of individuals over 85 years increased considerably while it decreased in the 65 to 74 and 75 to 84-year age groups. Bandyopadhyay et al pointed out that the proportion of RA patients with comorbidities, especially cardiovascular disease, increased from 2005 to 2014 [ 47 ]. It is worthwhile noting that both RA and diabetes increase the risk of cardiovascular disease [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study

Huang

Zheng

et al. 2020

International Journal of Endocrinology

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Background. Patients with diabetes mellitus are prone to develop osteoporosis, osteomyelitis, or rheumatoid arthritis (RA). Furthermore, the presence of these complications in those with diabetes may lead to higher mortality. The aim of our study was to assess characteristics and mortality of osteoporosis, osteomyelitis, or rheumatoid arthritis in individuals with diabetes. Methods. We analyzed osteoporosis, osteomyelitis, and RA deaths associated with diabetes from 1999–2017 using the CDC WONDER system (CDC WONDER; https://wonder.cdc.gov). We used ICD-10 codes to categorize the underlying and contributing causes of death. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 1,000,000 person-years were calculated. Results. The AAMR for osteoporosis in the population with diabetes was significantly higher in females (AAMR: 4.17, 95% CI: 4.10–4.24) than in males (AAMR: 1.12, 95% CI: 1.07–1.16). Deaths due to osteoporosis increased gradually from 1999, peaked in 2003 (AAMR: 3.78, 95% CI: 3.55–4.00), and reached a nadir in 2016 (AAMR: 2.32, 95% CI: 2.15–2.48). The AAMR for RA associated with diabetes was slightly higher in females (AAMR: 4.04, 95% CI: 3.98–4.11) than in males (AAMR: 2.45, 95% CI: 2.39–2.51). The mortality rate due to RA increased slightly from 1999 (AAMR: 3.18, 95% CI: 2.97–3.39) to 2017 (AAMR: 3.20, 95% CI: 3.02–3.38). The AAMR for osteomyelitis associated with diabetes was higher in males (AAMR: 4.36, 95% CI: 4.28–4.44) than in females (AAMR: 2.31, 95% CI: 2.26–2.36). From 1999 to 2017, the AAMR from osteomyelitis in this population was 2.63 (95% CI: 2.44–2.82) per 1,000,000 person-years in 1999 and 4.25 (95% CI: 4.05–4.46) per 1,000,000 person-years in 2017. Conclusions. We found an increase in the age-adjusted mortality rates of RA and osteomyelitis and a decrease of osteoporosis associated with diabetes from 1999 to 2017. We suggest that increased attention should therefore be given to these diseases in the population with diabetes, especially in efforts to develop preventative and treatment strategies.

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“…While earlier observational studies from different populations have reported increased mortality after acute MI in patients with RA versus non-RA subjects, including 30-day and 1-year mortality (31-33), a recent National Inpatient Sample database analysis showed no increase in in-hospital mortality following acute MI in patients with RA in 2005-2014 (34). In our study, mortality following incident MI and/or stroke showed potential improvement in patients with RA diagnosed after 1980s, while relative mortality was similar in patients with RA and non-RA subjects across the decades of the study.…”

Section: Mortality After Incident Cvd Events In Ramentioning

confidence: 90%

Improved Incidence of Cardiovascular Disease in Patients With Incident Rheumatoid Arthritis in the 2000s: A Population-based Cohort Study

et al. 2021

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Objective To assess trends in incidence of cardiovascular disease (CVD) and mortality following incident CVD events in patients with rheumatoid arthritis (RA) onset in 1980- 2009 versus non-RA subjects. Methods We studied Olmsted County, Minnesota residents with incident RA (age ≥ 18 years, 1987 ACR criteria met in 1980-2009) and non-RA subjects from the same source population with similar age, sex and calendar year of index. All subjects were followed until death, migration, or 12/31/2016. Incident CVD events included myocardial infarction and stroke. Patients with CVD before RA incidence/index date were excluded. Cox models were used to compare incident CVD events by decade, adjusting for age, sex and CVD risk factors. Results The study included 905 patients with RA and 904 non-RA subjects. Cumulative incidence of any CVD event was lower in patients with incident RA in 2000s versus 1980s. Hazard Ratio [HR] for any incident CVD 2000s versus 1980s: 0.53; 95% confidence interval (CI): 0.31-0.93. The strength of association attenuated after adjustment for anti-rheumatic medication use: HR 0.64, 95%CI 0.34-1.22. Patients with RA in 2000s had no excess in CVD over non-RA subjects (HR: 0.71, 95%CI:0.42-1.19). Risk of death after a CVD event was somewhat lower in patients with RA after 1980s: HR: 0.54, 95%CI:0.33-0.90 in 1990s and HR: 0.68, 95%CI:0.33-1.41 in 2000s versus 1980s. Conclusion Incidence of major CVD events in RA has declined in recent decades. The gap in CVD occurrence between RA patients and the general population is closing. Mortality after CVD events in RA may be improving.

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Trends of Cardiac Complications in Patients With Rheumatoid Arthritis: Analysis of the United States National Inpatient Sample; 2005-2014

Cited by 19 publications

References 48 publications

Trends in Hospitalization Rates, Major Causes of Hospitalization, and In‐Hospital Mortality in Rheumatoid Arthritis in the United States From 2000 to 2014

Trends in Hospitalization Rates, Major Causes of Hospitalization, and In‐Hospital Mortality in Rheumatoid Arthritis in the United States From 2000 to 2014

The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study

Improved Incidence of Cardiovascular Disease in Patients With Incident Rheumatoid Arthritis in the 2000s: A Population-based Cohort Study

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