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Trends in All-Cause and Cardiovascular Mortality in Patients With Incident Rheumatoid Arthritis: A 20-year Follow-Up Matched Case-Cohort Study
- Publication Year :
- 2019
-
Abstract
- Objectives To examine all-cause and cardiovascular disease (CVD) mortality in consecutive cohorts of patients with incident RA, compared with population comparators. Methods The Oslo RA register inclusion criteria were diagnosis of RA (1987 ACR criteria) and residency in Oslo. Patients with disease onset 1994–2008 and 10 matched comparators for each case were linked to the Norwegian Cause of Death Registry. Hazard ratios for all-cause and CVD mortality were calculated for 5, 10, 15 and 20 years of observation using stratified cox-regression models. Mortality trends were estimated by multivariate cox-regression. Results 443, 479 and 469 cases with disease incidence in the periods 94–98, 99–03 and 04–08 were matched to 4430, 4790 and 4690 comparators, respectively. For cases diagnosed between 1994 and 2003, the all-cause mortality of cases diverged significantly from comparators after 10 years of disease duration [hazard ratio (95% CI) 94–98 cohort 1.42 (1.15–1.75): 99–03 cohort 1.37 (1.08–1.73)]. CVD related mortality was significantly increased after 5 years for the 94–98 cohort [hazard ratio (95% CI) 1.86 (1.16–2.98) and after 10 years for the 99–03 cohort 1.80 (1.20–2.70)]. Increased mortality was not observed in the 04–08 cohort where cases had significantly lower 10-year all-cause and CVD mortality compared with earlier cohorts. Conclusion All-cause and CVD mortality were significantly increased in RA patients diagnosed from 1994 to 2003, compared with matched comparators, but not in patients diagnosed after 2004. This may indicate that modern treatment strategies have a positive impact on mortality in patients with RA.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Population
Disease
Arthritis, Rheumatoid
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
Epidemiology
Humans
Medicine
Pharmacology (medical)
Registries
030212 general & internal medicine
education
Aged
Cause of death
Aged, 80 and over
030203 arthritis & rheumatology
education.field_of_study
Norway
business.industry
Incidence
Hazard ratio
Middle Aged
medicine.disease
Survival Rate
Cardiovascular Diseases
Rheumatoid arthritis
Cohort
Female
business
Cohort study
Subjects
Details
- ISSN :
- 14620324
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....fd3b9506e1bbacc77e789d04ed366d9c