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For patients with rheumatoid arthritis (RA), there are common risk factors for venous thromboembolism (VTE) and atherosclerotic cardiovascular disease (ASCVD), and the risk for ASCVD is increased after unprovoked VTE, according to a study recently published in RMD Open.
Gulsen Ozen, M.D., from the University of Nebraska Medical Center in Omaha, and colleagues compared risk factors for VTE and ASCVD among patients with RA participating in a U.S.-wide longitudinal observational registry. The subsequent risk for ASCVD after an unprovoked VTE was assessed.
The researchers identified 539 unprovoked VTE and 1,648 ASCVD events during a median four years of follow-up in 31,366 patients with RA. In adjusted models, increased VTE and ASCVD risk were seen with older age, male sex, comorbidities, prior fracture, worse disability, and higher disease activity. In both patients with ASCVD and VTE, traditional cardiovascular disease risk factors were common, but they only increased ASCVD risk, with the exception of obesity, which was associated with an increased risk for VTE (hazard ratio, 1.46). After unprovoked VTE, the risk for ASCVD was increased twofold (hazard ratio, 2.05).
"Patients with RA with an unprovoked VTE had a doubled risk of developing an ASCVD," the authors write. "Our findings support that unprovoked VTE may be a spectrum of pan-cardiovascular syndrome in patients with RA and a risk factor for a future ASCVD."