At the European Congress of Rheumatology meeting, held June 9-12, 2004, a Stanford University investigator suggested that the cardiovascular risks attributable to rheumatoid arthritis (RA) have been underrecognized. More patients with RA are having heart attacks that necessitate hospital treatment, and in the past 10 years, hospital mortality rates following acute myocardial infarction (AMI) in those patients have not improved at all.
The researchers examined all hospitalized patients with a primary diagnosis of AMI and a secondary diagnosis of RA or diabetes. In 1991, nearly 11% of all patients with diabetes who were admitted for an AMI died. By 2001, the number was 7.7%—a 30% drop. In contrast, the case-fatality rate among patients with RA declined by just 0.03% per year. canadian antibiotics
The researchers suggest that the marked difference is attributable to the aggressive preventive and therapeutic treatment that diabetic patients now receive. Dealing with RA requires the same emphasis on modifying cardiovascular risk factors, such as improved routine screening for coronary disease. The investigators emphasized that only one third of RA patients were taking low-dose aspirin, despite the evidence that it reduces cardiovascular risk.
Other researchers at the meeting considered disease-modifying antirheumatic drugs (DMARDs) to be the best method of preventing cardiovascular disease in patients with RA. At McGill University in Montreal, one study found a 20% reduction in the risk of AMI. Current use of selective cyclooxygenase (COX-2) inhibitors, however, was associated with a 70% increase in risk.