Among people with rheumatoid arthritis, or RA, the risk of having a heart attack rises significantly in as little as one year after diagnosis, according to a new study published in the Journal of Internal Medicine.
“We already knew that patients with longstanding disease were at increased risk of myocardial infarction. But that this risk was increased this early in disease duration was surprising,” says lead author Marie Holmqvist, MD, PhD, who works in the Department of Medicine at Sweden’s Karolinska University Hospital in Stockholm.
Swedish researchers assessed the cardiac health of 7,469 RA patients, diagnosed between 1995 and 2006, and compared them with a group of more than 37,000 people without RA.
What they found was that heart attack risk rose 60 percent in one to four years after a patient was diagnosed with RA. The risk of other forms of heart disease rose 50 percent in the same time frame.
“Our finding [implies] that even patients with short disease duration could be at risk, and this emphasizes the importance of careful risk assessment, starting at the time of RA diagnosis,” Dr. Holmqvist explains. In fact, the quick increase in heart-attack risk was seen in patients who only had RA symptoms a short time before their diagnosis and who were aggressively treated for it.
“Rheumatologists should pay extra attention to heart disease risk in this population of patients with early RA, not just those with longstanding disease,” Dr. Holmqvist she says.
Although more follow-up would improve the findings’ reliability, patients and doctors should be taking this information seriously now, says Eric L. Matteson, MD, MPH, a consultant in rheumatology at the Mayo Clinic in Rochester, Minn.
“While not all of the contributing factors are understood, it is important to get the RA under control early, and early on in the disease address other well understood risk factors for heart disease, such as smoking, weight [and] cholesterol, and promote physical activity,” he adds.