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Thromb Haemost 2016; 115(02): 439-445
DOI: 10.1160/th15-07-0600
Atherosclerosis and Ischaemic Disease
Schattauer GmbH

Risk of peripheral arterial occlusive disease in patients with rheumatoid arthritis

A nationwide population-based cohort study
Ya-Wen Chuang
1   Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
,
Mei-Ching Yu
2   Department of Pediatric Nephrology, Chang Gung Children’s Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
,
Cheng-Li Lin
3   Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
4   College of Medicine, China Medical University, Taichung, Taiwan
,
Tung-Min Yu
1   Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
5   Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
,
Kuo-Hsiung Shu
1   Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
,
Shih-Ting Huang
1   Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
5   Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
,
Chia-Hung Kao
5   Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
6   Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
› Author Affiliations Financial support: This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212–113002); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092); NRPB Stroke Clinical Trial Consortium (MOST 103–2325-B-039–006); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
Further Information

Publication History

Received: 30 July 2015

Accepted after major revision: 04 September 2015

Publication Date:
22 November 2017 (online)

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Summary

Rheumatoid arthritis (RA) is associated with atherosclerosis. However, the relationship between RA and peripheral arterial occlusive disease (PAOD) remains unclear. We used a national health insurance database to identify a cohort of 30,812 patients diagnosed with RA between 2000 and 2011. Each RA patient was frequency-matched according to age and sex with a patient without RA from a control cohort. A multivariate Cox proportional hazards model was used to analyse the adjusted risk of PAOD. The incidence of PAOD was 1.73-fold higher (95 % confidence interval [CI] = 1.57–1.91) in the RA cohort than in the non-RA cohort. The adjusted risk of PAOD was the highest in the patients with RA aged ≤ 49 years (hazard ratio [HR] = 3.39, 95 % CI = 2.66–4.32). Patients with RA and various comorbidities showed a significantly higher risk of PAOD (HR = 9.62, 95 % CI = 4.86–19.1) compared with control patients without comorbidity. The risk of PAOD increased during the first year of follow-up. In conclusion, patients with RA have an independently higher risk of PAOD compared with the general population. Patients with RA and various comorbidities and those at a young age and early stage of the disease have an increased risk of PAOD.

Keywords

Rheumatoid arthritis - peripheral arterial occlusive disease - incidence - risk factors
 

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