Incidence Rate of Cardiovascular Events in Rheumatoid Arthritis: An Observational Cohort Study in Saudi Arabia

Abstract

Laila Saleh AlGhalawin,1 Mukhtar Alomar,1 Shahad Al Bassam,2 Aqeelah Abdullah AlHamdan,3 Hadeel Anan,4 Marwah Altaweel,5 Zainab Abbas Alomran,6 Reem Al khamis,7 Asma Ibrahim Alqatri,8 Marwan M Alamoudi,9 Ahmad Alamer10 1Pharmaceutical Care Affairs, Dammam Medical Complex, Eastern Health Cluster, Dammam, Saudi Arabia; 2Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Pharmacy Department, Al-Mana General Hospital, Dammam, Saudi Arabia; 4Pharmaceutical Care and Formulary Management Affairs, Eastern Health Cluster, Dammam, Saudi Arabia; 5Pharmaceutical Care Affairs, Saud AlBabtain Cardiac Center, Eastern Health Cluster, Dammam, Saudi Arabia; 6Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia; 7Independent Researcher, Dammam, Saudi Arabia; 8Pharmacy Department, Saudi German Hospital, Dammam, Saudi Arabia; 9Rheumatology Department, Dammam Medical Complex, Eastern Health Cluster, Dammam, Saudi Arabia; 10Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi ArabiaCorrespondence: Ahmad Alamer, Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, 16278, P.O. Box: 173, Alkharj, 11942, Saudi Arabia, Email [email protected]: Rheumatoid arthritis (RA) doubles the morbidity of cardiovascular disease (CVD) and leads to a 50% increase in mortality compared to the general population. This study aims to estimate the CVD incidence among RA patients in Saudi Arabia (SA), vital for assessing CVD burdens within this group.Patients and Methods: This retrospective study took place at two centers in the Eastern Province of SA, including all adult RA patients who visited the rheumatology clinic from 2016 to 2021 and were prescribed disease-modifying antirheumatic drugs (DMARDs). CVD incidence was determined by the diagnosis of ischemic heart disease (IHD), stroke/transient ischemic attack (TIA), venous thromboembolism (VTE), heart failure (HF), and arrhythmia post-RA diagnosis. Additional data collected included demographics, CVD risk factors, comorbidities, RA-related factors, and medication usage.Results: The study comprised 651 patients, 80.5% of whom were females with an average age of 51. The overall CVD incidence was 11.2 per 1000 person-years, with males experiencing five times more incidents than females. The prevalence of CVD risk factors included 18.7% with hypertension, 7.8% with hyperlipidemia, 18.9% with diabetes, and 42.9% with obesity. Significant predictors of CVD were male gender and RA duration, with adjusted odds ratios (aOR) of 3.17 (95% CI 1.10 to 9.14, P=0.033) and 64.81 (95% CI 3.68 to 1140.6, P=0.004), respectively.Conclusion: This unique study from SA examined the CVD incidence in RA patients, identifying long disease duration and male gender as significant predictors. Effective reduction of CVD risk in RA patients requires aggressive management of modifiable risk factors and regular risk assessments.Keywords: cardio-rheumatology, cardiovascular, arrhythmia, autoimmune arthritis, anti-rheumatic

Keywords

• cardio-rheumatology
• cardiovascular
• arrhythmia
• autoimmune arthritis
• anti-rheumatic