Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA...

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Autores principales:	Arjun Sinha, Adovich S. Rivera, Simran A. Chadha, Sameer Prasada, Anna E. Pawlowski, Edward Thorp, Matthew DeBerge, Rosalind Ramsey-Goldman, Yvonne C. Lee, Chad J. Achenbach, Donald M. Lloyd-Jones, Matthew J. Feinstein
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	coronary heart disease lupus (SLE) systemic sclerosis inflammation rheumatoid arthritis HIV–human immunodeficiency virus Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/6a631f0f83c8405e811d0175404a1481
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spelling	oai:doaj.org-article:6a631f0f83c8405e811d0175404a14812021-11-10T07:07:54ZComparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases2297-055X10.3389/fcvm.2021.757738https://doaj.org/article/6a631f0f83c8405e811d0175404a14812021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.757738/fullhttps://doaj.org/toc/2297-055XBackground: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.Arjun SinhaArjun SinhaAdovich S. RiveraAdovich S. RiveraSimran A. ChadhaSameer PrasadaAnna E. PawlowskiEdward ThorpMatthew DeBergeRosalind Ramsey-GoldmanYvonne C. LeeChad J. AchenbachDonald M. Lloyd-JonesDonald M. Lloyd-JonesMatthew J. FeinsteinMatthew J. FeinsteinFrontiers Media S.A.articlecoronary heart diseaselupus (SLE)systemic sclerosisinflammationrheumatoid arthritisHIV–human immunodeficiency virusDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary heart disease lupus (SLE) systemic sclerosis inflammation rheumatoid arthritis HIV–human immunodeficiency virus Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	coronary heart disease lupus (SLE) systemic sclerosis inflammation rheumatoid arthritis HIV–human immunodeficiency virus Diseases of the circulatory (Cardiovascular) system RC666-701 Arjun Sinha Arjun Sinha Adovich S. Rivera Adovich S. Rivera Simran A. Chadha Sameer Prasada Anna E. Pawlowski Edward Thorp Matthew DeBerge Rosalind Ramsey-Goldman Yvonne C. Lee Chad J. Achenbach Donald M. Lloyd-Jones Donald M. Lloyd-Jones Matthew J. Feinstein Matthew J. Feinstein Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
description	Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.
format	article
author	Arjun Sinha Arjun Sinha Adovich S. Rivera Adovich S. Rivera Simran A. Chadha Sameer Prasada Anna E. Pawlowski Edward Thorp Matthew DeBerge Rosalind Ramsey-Goldman Yvonne C. Lee Chad J. Achenbach Donald M. Lloyd-Jones Donald M. Lloyd-Jones Matthew J. Feinstein Matthew J. Feinstein
author_facet	Arjun Sinha Arjun Sinha Adovich S. Rivera Adovich S. Rivera Simran A. Chadha Sameer Prasada Anna E. Pawlowski Edward Thorp Matthew DeBerge Rosalind Ramsey-Goldman Yvonne C. Lee Chad J. Achenbach Donald M. Lloyd-Jones Donald M. Lloyd-Jones Matthew J. Feinstein Matthew J. Feinstein
author_sort	Arjun Sinha
title	Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
title_short	Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
title_full	Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
title_fullStr	Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
title_full_unstemmed	Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases
title_sort	comparative risk of incident coronary heart disease across chronic inflammatory diseases
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/6a631f0f83c8405e811d0175404a1481
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Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

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