Dhruv Mahtta1, Angela Gupta2, David J Ramsey3, Mahmoud Al Rifai4, Anurag Mehta5, Chayakrit Krittanawong4, Michelle T Lee6, Khurram Nasir7, Zainab Samad8, Roger S Blumenthal9, Hani Jneid10, Christie M Ballantyne11, Laura A Petersen12, Salim S Virani13. 1. Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center, Houston, Tex; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Tex. 2. Department of Medicine, University Hospitals Cleveland Medical Center, and Case Western Reserve University School of Medicine, Cleveland, Ohio. 3. Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center, Houston, Tex. 4. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Tex. 5. Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Ga. 6. Department of Medicine, University of Texas Health Science Center, Houston. 7. Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Tex. 8. Department of Medicine, The Aga Khan University, Karachi, Pakistan. 9. Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md. 10. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Tex; Section of Cardiology, Michael E. DeBakey VA Medical Center, Houston, Tex. 11. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Tex; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Tex. 12. Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center, Houston, Tex; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Tex. 13. Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center, Houston, Tex; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Tex; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Tex; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Tex. Electronic address: virani@bcm.edu.
Abstract
BACKGROUND: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. METHODS: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. RESULTS: Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. CONCLUSION: Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients. Published by Elsevier Inc.
BACKGROUND: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atherosclerotic cardiovascular disease. METHODS: The Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males <55 years, females <65 years) and extremely premature atherosclerotic cardiovascular disease (<40 years), was created from the 2014-2015 nationwide Veterans Affairs (VA) health care system database. We assessed age at the time of first cardiovascular event to compare patients with premature (n = 135,703) and those with extremely premature atherosclerotic cardiovascular disease (n = 7716) with age-matched patients without atherosclerotic cardiovascular disease (nyoung = 1,153,535, nextremely young = 441,836). We assessed whether systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis were independently associated with premature and extremely premature atherosclerotic cardiovascular disease. RESULTS:Patients with premature and extremely premature atherosclerotic cardiovascular disease had a higher prevalence of all rheumatic diseases as compared with age-matched patients without atherosclerotic cardiovascular disease. In fully adjusted models, systemic lupus erythematosus (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.56-1.83) and rheumatoid arthritis (OR: 1.72, 95% CI: 1.63-1.81) were associated with increased odds of premature atherosclerotic cardiovascular disease. Patients with systemic lupus erythematosus (OR: 3.06, 95% CI: 2.38-3.93) and rheumatoid arthritis (OR: 2.39, 95% CI: 1.85-3.08) also had a higher likelihood of extremely premature atherosclerotic cardiovascular disease. CONCLUSION:Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease. Future studies are needed to understand the rheumatic disease-specific factors behind the development and progression of clinical atherosclerotic cardiovascular disease in these young patients. Published by Elsevier Inc.
Authors: Der-Yuan Chen; Tatsuya Sawamura; Richard A F Dixon; José Luis Sánchez-Quesada; Chu-Huang Chen Journal: J Clin Med Date: 2021-05-06 Impact factor: 4.241
Authors: Dhruv Mahtta; David J Ramsey; Mahmoud Al Rifai; Khurram Nasir; Zainab Samad; David Aguilar; Hani Jneid; Christie M Ballantyne; Laura A Petersen; Salim S Virani Journal: JAMA Netw Open Date: 2020-08-03
Authors: Khurram Nasir; Isaac Acquah; Amit K Dey; Tanushree Agrawal; Syed Zawahir Hassan; Kerri Glassner; Bincy Abraham; Eamonn M M Quigley; Ron Blankstein; Salim S Virani; Michael J Blaha; Javier Valero-Elizondo; Miguel Cainzos-Achirica; Nehal N Mehta Journal: Am J Prev Cardiol Date: 2022-01-17
Authors: Tanushree Agrawal; Isaac Acquah; Amit K Dey; Kerri Glassner; Bincy Abraham; Ron Blankstein; Salim S Virani; Michael J Blaha; Javier Valero-Elizondo; Nehal Mehta; Eamonn Mm Quigley; Miguel Cainzos-Achirica; Khurram Nasir Journal: Am J Prev Cardiol Date: 2021-03-16