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RA Disability Predictive of Cardiac Mortality in Polyarthritis

Early functional disability independently predicted cardiovascular disease-related mortality as well as all-cause mortality in patients with inflammatory polyarthritis, investigators reported.

The finding builds on other studies demonstrating the predictive value of early functional disability in rheumatoid arthritis (RA), and “may help guide the targeting of aggressive therapies,” reported Tracey M. Farragher of the University of Manchester (England), and associates.

The investigators used the Norfolk Arthritis Register, in Norwich, England, to determine if early functional disability is a useful independent predictor of increased cardiac risk.

Disability was measured at baseline and again at 1 year using the Health Assessment Questionnaire (HAQ).

Patients were referred to the registry if they had swelling of at least two joints for at least 4 weeks. About 45% were classified as having RA at referral, and by 5 years about 67% had satisfied the American College of Rheumatology criteria for RA. All patients (mean age 54 years) were followed until death or for 10 years after registration, whichever came first.

By 10 years, 171 (17%) of 1,010 patients had died, and 89 (52%) of those deaths were attributed to cardiovascular disease.

Both all-cause mortality and cardiovascular disease-related mortality increased sharply as the HAQ scores from either the baseline assessment or the 1-year follow-up increased, the investigators reported (Ann. Rheum. Dis. 2006 Nov. 7 [Epub doi: 10.1136/ard.2006.056390]).

When year 1 HAQ scores were focused on and adjusted for other predictors, the investigators found that functional disability and rheumatoid factor positivity were independent predictors of subsequent early death, including cardiac death, according to the investigators. With each one-point increase in HAQ score, patients had a 48% higher risk of dying within the follow-up period, and a 52% higher risk of dying from cardiovascular disease.

Using HAQ scores obtained at baseline, the investigators found that while disability was a significant risk factor (increasing the risk of all-cause death and cardiovascular disease death by 27% and 15%, respectively, for each 1-point increase in HAQ score), rheumatoid factor positivity was the only independent predictor of all-cause and cardiovascular disease mortality. The investigators repeated the analysis for patients who satisfied ACR criteria for RA by 5 years, and found that the predictive value of 1-year HAQ scores was similar to the predictive value for patients with inflammatory polyarthritis and not RA.

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Early functional disability independently predicted cardiovascular disease-related mortality as well as all-cause mortality in patients with inflammatory polyarthritis, investigators reported.

The finding builds on other studies demonstrating the predictive value of early functional disability in rheumatoid arthritis (RA), and “may help guide the targeting of aggressive therapies,” reported Tracey M. Farragher of the University of Manchester (England), and associates.

The investigators used the Norfolk Arthritis Register, in Norwich, England, to determine if early functional disability is a useful independent predictor of increased cardiac risk.

Disability was measured at baseline and again at 1 year using the Health Assessment Questionnaire (HAQ).

Patients were referred to the registry if they had swelling of at least two joints for at least 4 weeks. About 45% were classified as having RA at referral, and by 5 years about 67% had satisfied the American College of Rheumatology criteria for RA. All patients (mean age 54 years) were followed until death or for 10 years after registration, whichever came first.

By 10 years, 171 (17%) of 1,010 patients had died, and 89 (52%) of those deaths were attributed to cardiovascular disease.

Both all-cause mortality and cardiovascular disease-related mortality increased sharply as the HAQ scores from either the baseline assessment or the 1-year follow-up increased, the investigators reported (Ann. Rheum. Dis. 2006 Nov. 7 [Epub doi: 10.1136/ard.2006.056390]).

When year 1 HAQ scores were focused on and adjusted for other predictors, the investigators found that functional disability and rheumatoid factor positivity were independent predictors of subsequent early death, including cardiac death, according to the investigators. With each one-point increase in HAQ score, patients had a 48% higher risk of dying within the follow-up period, and a 52% higher risk of dying from cardiovascular disease.

Using HAQ scores obtained at baseline, the investigators found that while disability was a significant risk factor (increasing the risk of all-cause death and cardiovascular disease death by 27% and 15%, respectively, for each 1-point increase in HAQ score), rheumatoid factor positivity was the only independent predictor of all-cause and cardiovascular disease mortality. The investigators repeated the analysis for patients who satisfied ACR criteria for RA by 5 years, and found that the predictive value of 1-year HAQ scores was similar to the predictive value for patients with inflammatory polyarthritis and not RA.

Early functional disability independently predicted cardiovascular disease-related mortality as well as all-cause mortality in patients with inflammatory polyarthritis, investigators reported.

The finding builds on other studies demonstrating the predictive value of early functional disability in rheumatoid arthritis (RA), and “may help guide the targeting of aggressive therapies,” reported Tracey M. Farragher of the University of Manchester (England), and associates.

The investigators used the Norfolk Arthritis Register, in Norwich, England, to determine if early functional disability is a useful independent predictor of increased cardiac risk.

Disability was measured at baseline and again at 1 year using the Health Assessment Questionnaire (HAQ).

Patients were referred to the registry if they had swelling of at least two joints for at least 4 weeks. About 45% were classified as having RA at referral, and by 5 years about 67% had satisfied the American College of Rheumatology criteria for RA. All patients (mean age 54 years) were followed until death or for 10 years after registration, whichever came first.

By 10 years, 171 (17%) of 1,010 patients had died, and 89 (52%) of those deaths were attributed to cardiovascular disease.

Both all-cause mortality and cardiovascular disease-related mortality increased sharply as the HAQ scores from either the baseline assessment or the 1-year follow-up increased, the investigators reported (Ann. Rheum. Dis. 2006 Nov. 7 [Epub doi: 10.1136/ard.2006.056390]).

When year 1 HAQ scores were focused on and adjusted for other predictors, the investigators found that functional disability and rheumatoid factor positivity were independent predictors of subsequent early death, including cardiac death, according to the investigators. With each one-point increase in HAQ score, patients had a 48% higher risk of dying within the follow-up period, and a 52% higher risk of dying from cardiovascular disease.

Using HAQ scores obtained at baseline, the investigators found that while disability was a significant risk factor (increasing the risk of all-cause death and cardiovascular disease death by 27% and 15%, respectively, for each 1-point increase in HAQ score), rheumatoid factor positivity was the only independent predictor of all-cause and cardiovascular disease mortality. The investigators repeated the analysis for patients who satisfied ACR criteria for RA by 5 years, and found that the predictive value of 1-year HAQ scores was similar to the predictive value for patients with inflammatory polyarthritis and not RA.

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RA Disability Predictive of Cardiac Mortality in Polyarthritis
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