Pos0211 association between cardiovascular outcome and rheumatoid arthritis: nationwide population-based cohort study

BackgroundMany studies have shown increased risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). Despite a growing burden posed by CVD in RA patients, large scale studies which examined the association between characteristic of RA patients and CVD risks, and studies which adjusted for various confounding factors are lacking.ObjectivesThis study aimed to investigate the association between CVD risk and RA in large-scale, nationwide cohort of Korean population, and to examine which characteristics of RA patients are associated with increased CVD risk.MethodsWe enrolled 136,469 patients with RA who participated in national health examinations within 2 years of RA diagnosis between 2010 and 2017 and non-RA controls matched by age and sex (n= 682,345). The cohort was followed until the end of 2019. The outcome was occurrence of myocardial infarction (MI) or stroke. MI was defined as one hospitalization or two outpatient visit with ICD-10-CM codes I21 or I22. Stroke was defined as one hospitalization with ICD-10-CM codes I63 or I64 and a claim for brain imaging (CT or MRI). The Cox proportional hazard model and Kaplan Meier curve were used for the analysis.ResultsMean follow up duration was 4.7 years. The incidence rate of CVD was higher in RA group than control (MI: 3.20 vs 2.08; stroke: 2.84 vs 2.33 per 1,000 person-years). The risk of CVD was higher in RA patients. (MI: adjusted HR 1.54, 95% CI 1.46-1.61; Stroke: adjusted HR 1.22, 95% CI 1.16-1.28). The association between RA and CVD was prominent in female (MI: adjusted HR 1.41 in male, 1.60 in female, p for interaction = 0.0293; Stroke: adjusted HR 1.13 in male, 1.27 in female, p for interaction = 0.03) and younger-age subgroups (MI: adjusted HR 2.9 in <40 years, 1.52 in 40-64 years, 1.51 in ≥65 years, p for interaction<0.0001; Stroke: adjusted HR 2.35 in <40 years, 1.21 in 40-64 years, 1.21 in ≥65 years, p for interaction = 0.0100) after adjusting for confounding variables. The association between RA and risk of MI was significant in those without DM. (adjusted HR 1.30 in DM, 1.61 in non-DM, p for interaction = 0.0005)ConclusionRA patients had increased risk of CVD events compared to age- and sex-matched control group, and this association was stronger in female and younger-age subgroups. Therefore appropriate screening for CVD would be important in all RA patients including female and younger patients.Disclosure of InterestsNone declared