Incidence and outcome of cardiovascular disease in patients with inflammatory joint diseases

Concept

Patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) have a 1.5- to 2-fold increased risk of cardiovascular disease (CVD) compared to the general population. To be able to prevent CVD in patients with inflammatory joint diseases (IJD), it is of great importance to provide up-to-date

evidence on the prevalence of CVD and the effect of medication on CVD outcome. We establish a Norwegian Cardio-Rheuma register with data on the whole Norwegian population >18 years including all patients with IJD from 2008 – 2017 through linkage between Norwegian national registers. The design is observational cohort study and individuals with and without IJD will be compared. Our research team has obtained concession from the Norwegian General Data Protection Regulation (GDPR) (16/00482-11/CDG) to establish the Norwegian Cardio-Rheuma register, and the project has been recommended by the South East Health Authority Ethical Committee (2016/588) and by the Data Protection Officer, Oslo University Hospital (2016/924) and a GDPR including DPIA evaluation has been performed (5/12-2019).

Facts and figures

Project lead
A Semb
Diakonhjemmet Hospital
anne.kerola@helsinki.fi
FOREUM reserach grant: € 50'000
2020–2021

Meet the team

A Semb
Diakonhjemmet Hospital
A Kerola
University of Helsinki
M Kauppi
Päijät-Häme Central Hospital
T Nieminen
Päijät-Häme Central Hospital
E Haarvardsholm
Diakonhjemmet Hospital
S Rollefstad
Department of Rheumatology, Diakonhjemmet Hospital
G Wibetoe
Department of Rheumatology, Diakonhjemmet Hospital
Eirik Ikdahl
Department of Rheumatology, Diakonhjemmet Hospital

Objectives

  • To evaluate CVD morbidity and mortality in patients with RA, AS and PsA compared to the general population. We will study prevalence, incidence and outcome of the most common CVDs, and explore trends in CVD mortality and morbidity during the 10-year period.
  • To compare the prevalence of CVD in users and non-users of biologic disease-modifying antirheumatic drugs in patients with IJD and the general population.
  • To explore sex differences in CVD event rates in patients with IJD compared to the general population.
  • To compare the use of secondary preventive medication in patients with IJD and stable coronary heart disease (CHD) or after acute coronary syndrome (ACS) vs. general population controls with stable CHD or after ACS and the effect on CVD outcome.

The results from this project may facilitate the establishment of CVD prevention recommendations/ guidelines specifically developed for patients with IJD.

Patient voice

Two patient representatives, one from the patient user council of Diakonhjemmet hospital and one from the National Association of Rheumatology, are involved in all stages of the project. We aim to have regular meetings and communication with the patient representatives to include them in the development of protocol writing, choice of outcome measures, final analyses and presentation and dissemination of results. The Department of Rheumatology in Diakonhjemmet Hospital also has an established rheumatology patient

Council, who will be consulted for relevant user input and presentation of results. We will actively seek to disseminate results from the projects to patients through lay summaries and presentations at patient organizations meetings.