Trends in the occurrence of ischaemic heart disease over time in rheumatoid arthritis: 1821 patients from 1972 to 2017

Abstract

Objective

To evaluate trends of acute myocardial infarction (AMI) and ischaemic heart disease (IHD) in rheumatoid arthritis (RA) patients compared with the general population over time.

Method

We performed a retrospective cohort study of 1821 RA patients diagnosed from 1972 to 2013. Aggregated counts of the total population of the same county (Hordaland, Norway) and period were used for comparison. Information on AMI and IHD events was obtained from hospital patient administrative systems or cardiovascular registries. We estimated incidence rates and excess of events [standardized event ratio (SER) with 95% confidence interval (CI)] compared with the general population by Poisson regression.

Results

There was an average annual decline of 1.6% in age- and gender-adjusted AMI incidence rates from 1972 to 2017 (p < 0.035). The difference in events (excess events) in RA patients compared with the general population declined on average by 1.3% per year for AMI and by 2.3% for IHD from 1972 to 2014. There were no significant excess AMI (SER 1.05, 95% CI 0.82–1.35) or IHD events (SER 1.02, 95% CI 0.89–1.16) for RA patients diagnosed after 1998 compared with the general population.

Conclusion

Incidence rates and excess events of AMI and IHD in RA patients declined from 1972 to 2017. There were no excess AMI or IHD events in RA patients diagnosed after 1998 compared with the general population.

Acknowledgements

The authors thank Tomislav Dimoski at the Norwegian Knowledge Centre for the Health Services, Norway, for his contribution in developing the software necessary for obtaining data from Norwegian hospitals, conducting the data collection, and quality assurance of data in the CVDNOR project. The interpretation and reporting of the data are the sole responsibility of the authors, and no endorsement by the Norwegian Cause of Death Registry is intended or should be inferred.

Disclosure statement

CL Alsing reports grants from Western Norway Regional Health Authority during the conduct of the study. BT Fevang reports attendance of an advisory board meeting by Eli Lilly Norge A.S Customer Meeting Services where travel expenses were paid by the company.

Supplemental data

Supplemental data for this article can be accessed https://doi.org/10.1080/03009742.2022.2040116.

Additional information

Funding

This work was supported by Helse Vest, Aslaug Andersen’s Memorial Fund, and Marit Hansen’s Memorial Fund.