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Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China

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Abstract

This study aims to assess the risk factors of cardiovascular disease (CVD) and to determine the association of traditional and biologic disease-modifying anti-rheumatic drugs (DMARDs) with risk for CVD in Chinese rheumatoid arthritis (RA) patients. A cross-sectional cohort of 2013 RA patients from 21 hospitals around China was established. Medical history of CVD was documented. The patients’ social background, clinical manifestations, comorbidities, and medications were also collected. Of the 2013 patients, 256 had CVD with an incidence of 12.7%. Compared with non-CVD controls, RA patients with CVD had a significantly advanced age, long-standing median disease duration, more often male and more deformity joints. Patients with CVD also had higher rates of smoking, rheumatoid nodules, interstitial lung disease, and anemia. The prevalence of comorbidities, including hypothyroidism, diabetes mellitus (DM), hypertension, and hyperlipidemia, was also significant higher in the CVD group. In contrast, patients treated with methotrexate, hydroxychloroquine (HCQ), and TNF blockers had lower incidence of CVD. The multivariate analysis showed that the use of HCQ was a protective factor of CVD, while hypertension, hyperlipidemia, and interstitial lung disease were independent risk factors of CVD. Our study shows that the independent risk factors of CVD include hypertension, hyperlipidemia, and interstitial lung disease. HCQ reduces the risk of CVD in patients with RA.

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Acknowledgments

We are very grateful to the patients and their families for their cooperation and for giving consent to participate in this study.

Author information

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Peking University People’s Hospital, 11 South Xizhimen Street, Beijing, 100044, China

    Chun Li, H. J. Ji, X. Y. Zhang, Yin Su, Rong Mu & Z. G. Li

  2. Department of Rheumatology and Immunology, Peking University Shougang Hospital, 9 Jinyuanzhuang Street, Beijing, 100144, China

    X. R. Wang & S. L. Han

  3. Department of Rheumatology and Immunology, The Second Affiliated Hospital Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China

    X. F. Li, L. Z. Wang & C. H. Wang

  4. Department of Rheumatology and Immunology, The First Affiliated Hospital, Baotou Medical College, 41 Linyin Road, Baotou, 014010, China

    Y. F. Wang & Rong Yang

  5. Department of Rheumatology and Immunology, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China

    G. C. Wang & Xin Lu

  6. Department of Rheumatology and Immunology, Xijing Hospital, 15 Changle Road, Xian, 710032, China

    Ping Zhu & L. N. Chen

  7. Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China

    H. T. Jin & J. T. Liu

  8. Department of Rheumatology and Immunology, Peking University Third Hospital, 49 North Garden Rd, Beijing, 100191, China

    X. Y. Liu & Lin Sun

  9. Department of Rheumatology and Immunology, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050000, China

    H. Y. Chen, Ping Wei & J. X. Wang

  10. Department of Rheumatology and Immunology, Kailuan Hospital of North China Coal Hospital, 57 West Xinhua Rd, Tangshan, 063000, China

    L. F. Cui, Rong Shu & B. L. Liu

  11. Department of Rheumatology and Immunology, Peking University First Hospital, 8 Xishiku Road, Beijing, 100034, China

    Z. L. Zhang & G. T. Li

  12. Department of Rheumatology and Immunology, Peace Hospital, 398 West Zhongshan Rd, Shijiazhuang, 050082, China

    Z. B. Li & Jing Yang

  13. Department of Rheumatology and Immunology, Hebei Handan Central Hospital, 311 Heping Rd, Handan, 056001, China

    J. F. Li & Bin Jia

  14. Department of Rheumatology and Immunology, Hebei People’s Hospital, 348 West Heping Rd, Shijiazhuang, 050051, China

    F. X. Zhang & J. M. Tao

  15. Department of Rheumatology and Immunology, The People’s Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Rd, Nanning, 530021, China

    J. Y. Lin & M. Q. Wei

  16. Department of Rheumatology and Immunology, Beijing Shunyi Hospital of China Medical University, 3 South Guangming Rd, Beijing, 101300, China

    X. M. Liu & Dan Ke

  17. Department of Rheumatology and Immunology, Tongji Medical College Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China

    S. X. Hu & Cong Ye

  18. Department of Rheumatology and Immunology, First Affiliated Hospital of Sun Yat-sen University, 58 Second Zhongshan Rd, Guangzhou, 510080, China

    X. Y. Yang & Hao Li

  19. Department of Rheumatology and Immunology, Beijing Hospital, 1 Dahua Rd, Beijing, 100730, China

    C. B. Huang, Ming Gao & Bei Lai

  20. Department of Rheumatology and Immunology, Qilu Hospital of Shandong University, 107 Jinan Culture Road, Jinan, 250012, China

    X. F. Li & L. J. Song

  21. Department of Rheumatology and Immunology, Second Hospital of Lanzhou University, 82 Cuiyingmen Rd, Lanzhou, 730030, China

    Yi Wang & X. Y. Wang

  22. Department of Cardiology, Fuwai Hospital, North Lishi Road, Beijing, 100037, China

    Y. D. Tang

Authors
  1. Chun Li
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  2. X. R. Wang
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  3. H. J. Ji
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  4. X. Y. Zhang
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  5. X. F. Li
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  6. L. Z. Wang
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  7. C. H. Wang
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  8. Y. F. Wang
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  9. Rong Yang
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  10. G. C. Wang
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  11. Xin Lu
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  12. Ping Zhu
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  13. L. N. Chen
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  14. H. T. Jin
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  15. J. T. Liu
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  16. X. Y. Liu
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  17. Lin Sun
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  18. H. Y. Chen
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  19. Ping Wei
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  20. J. X. Wang
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  21. L. F. Cui
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  22. Rong Shu
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  23. B. L. Liu
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  24. Z. L. Zhang
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  25. G. T. Li
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  26. Z. B. Li
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  27. Jing Yang
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  28. J. F. Li
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  29. Bin Jia
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  30. F. X. Zhang
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  31. J. M. Tao
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  32. S. L. Han
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  33. J. Y. Lin
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  34. M. Q. Wei
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  35. X. M. Liu
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  36. Dan Ke
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  37. S. X. Hu
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  38. Cong Ye
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  39. X. Y. Yang
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  40. Hao Li
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  41. C. B. Huang
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  42. Ming Gao
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  43. Bei Lai
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  44. X. F. Li
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  45. L. J. Song
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  46. Yi Wang
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  47. X. Y. Wang
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  48. Y. D. Tang
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  49. Yin Su
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  50. Rong Mu
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  51. Z. G. Li
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Corresponding authors

Correspondence to Rong Mu or Z. G. Li.

Ethics declarations

The study was approved by the Ethics Committee of Peking University People’s Hospital, and informed written consents were obtained from all study participants (FWA00001384).

Disclosures

None.

Funding

Supported by National High Technology Research and Development Program of China (973 Program, 2012CB517700) and National Natural Science Foundation of China (NSFC, No. 81202297)

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Li, C., Wang, X.R., Ji, H.J. et al. Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China. Clin Rheumatol 36, 1023–1029 (2017). https://doi.org/10.1007/s10067-017-3596-7

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  • DOI: https://doi.org/10.1007/s10067-017-3596-7

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