Medical Sciences (Feb 2019)
Assessment of Cardiovascular Disease Risk and Therapeutic Patterns among Urban Black Rheumatoid Arthritis Patients
- Isabel M. McFarlane,
- Su Yien Zhaz Leon,
- Manjeet S. Bhamra,
- Aaliya Burza,
- Stephen Anthony Waite,
- Milena Rodriguez Alvarez,
- Kristaq Koci,
- Nicholas Taklalsingh,
- Ian Kaplan,
- Joshy Pathiparampil,
- Naureen Kabani,
- Elsie Watler,
- Cristina S. Sorrento,
- Mosab Frefer,
- Vytas Vaitkus,
- Jason Green,
- Keron Matthew,
- Fray Arroyo-Mercado,
- Helen Lyo,
- Faisal Soliman,
- Randolph A. Sanchez,
- Felix M. Reyes,
- David J. Ozeri,
- Veena Dronamraju,
- Michael Trevisonno,
- Christon Grant,
- Guerrier Clerger,
- Khabbab Amin,
- Latoya Freeman,
- Makeda Dawkins,
- Diana Lenis Lopez,
- Jonathan Smerling,
- Irfan Gondal,
- Elaine Dellinger,
- Karen Paltoo,
- Hina Bhat,
- Srinivas Kolla
Affiliations
- Isabel M. McFarlane
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Su Yien Zhaz Leon
- Samaritan Medical Center Department of Rheumatology, Watertown, NY 13601, USA
- Manjeet S. Bhamra
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Aaliya Burza
- Department of Medicine, Division of Pulmonary and Critical Care State, SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Stephen Anthony Waite
- Department of Radiology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Milena Rodriguez Alvarez
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Kristaq Koci
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Nicholas Taklalsingh
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Ian Kaplan
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Joshy Pathiparampil
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Naureen Kabani
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Elsie Watler
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Cristina S. Sorrento
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Mosab Frefer
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Vytas Vaitkus
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Jason Green
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Keron Matthew
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Fray Arroyo-Mercado
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Helen Lyo
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Faisal Soliman
- Department of Geriatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11201, USA
- Randolph A. Sanchez
- Department of Rheumatology, Hahnemann Hospital, Philadelphia, PA 19019, USA
- Felix M. Reyes
- Department of Family and Social Medicine, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, NY 10468, USA
- David J. Ozeri
- Sheba Medical Center, Tel Aviv 6100000, Israel
- Veena Dronamraju
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Michael Trevisonno
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Christon Grant
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Guerrier Clerger
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Khabbab Amin
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Latoya Freeman
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Makeda Dawkins
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Diana Lenis Lopez
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Jonathan Smerling
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Irfan Gondal
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Elaine Dellinger
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Karen Paltoo
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Hina Bhat
- Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- Srinivas Kolla
- Department of Radiology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA
- DOI
- https://doi.org/10.3390/medsci7020031
- Journal volume & issue
-
Vol. 7,
no. 2
p. 31
Abstract
Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we identified 503 RA patients ≥18 years old who were seen from 2010 to 2017. Of them, 88.5% were Black, 87.9% were women and 29.4% were smokers. CVD risk factors (obesity, diabetes, hypertension, dyslipidemia) were higher than in previously reported White RA cohorts. Eighty-seven percent of the patients had at least one traditional CVD risk factor, 37% had three or more traditional CVD risk factors and 58% had RA-specific risk factors (seropositive RA, >10 years of disease, joint erosions, elevated inflammatory markers, extra-articular disease, body mass index (BMI) < 20). CV outcomes (coronary artery disease/myocardial infarction, heart failure, atrial fibrillation and stroke) were comparable to published reports. Higher steroid use, which increases CVD risk, and lesser utilization of biologics (decrease CV risk) were also observed. Our Black RA cohort had higher rates of traditional CVD risk factors, in addition to chronic inflammation from aggressive RA, which places our patients at a higher risk for CVD outcomes, calling for revised risk stratification strategies and effective interventions to address comorbidities in this vulnerable population.
Keywords
- rheumatoid arthritis
- traditional risk factors
- rheumatoid arthritis specific risk factors
- seropositive rheumatoid arthritis
- erosive disease
- extra-articular manifestations
- cardiovascular outcomes
- therapeutic patterns