The Frequency of Cardiovascular Diseases in Rheumatoid Arthritis in Brazil: 10-year Cohort Study with DATASUS Databases.

Arquivos brasileiros de cardiologia Pub Date : 2025-03-21 eCollection Date: 2025-01-01 DOI:10.36660/abc.20240313

Roberto Gamarski, Fernando Ferreira de Castro, Jose Antonio Sena do Nascimento, Mirhelen Mendes de Abreu

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Abstract

Background: Cardiovascular outcomes in patients with rheumatoid arthritis (RA) have been extensively explored in the literature concerning biological factors.

Objectives: This nationwide retrospective cohort study aimed to explore the distribution of cardiovascular events in patients with RA in Brazil, assisted by the Unified Health System (SUS), and to identify factors associated with these outcomes.

Methods: Patients aged ≥ 18 years were identified from the Brazilian Unified Health System Database (DATASUS) through RA ICD-10 codes and their therapeutic procedures according to SUS guidelines. RA patients treated with disease-modifying antirheumatic drugs (DMARDs) were categorized as biological users and non-biological (synthetic) users. Cardiovascular outcomes, including acute coronary artery disease (ACAD), heart failure, and cerebrovascular accident (CVA), were analyzed. Patients were also categorized based on treatment patterns (switch or constant users). Socioeconomic status was assessed using the FIRJAN Municipal Development Index (IFDM). Descriptive analyses identified population distribution and cardiovascular outcomes, and multiple logistic regression explored associated factors. The statistical significance adopted was p < 0.05.

Results: Among the 4,321 patients with RA treated with DMARDS, 198 cardiovascular outcomes (4.68%) were identified. The majority were female (3,398 [80.3%]) with a mean age of 54.2 (standard deviation 12.8) years, predominantly from the Southeast Region (2,421 [57.2%]). The predominant overall IFDM was > 0.8 (47.5%). Advanced age, the presence of cardiovascular risk factors, and the use of synthetic DMARDs were associated with cardiovascular outcomes.

Conclusion: Cardiovascular outcomes in patients with RA are common and are associated with age, comorbidities, and the drugs used for treatment.

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巴西类风湿关节炎患者心血管疾病的发生频率：DATASUS数据库的10年队列研究

背景：类风湿性关节炎（RA）患者的心血管结局在生物学因素方面的文献中得到了广泛的探讨。目的：在统一卫生系统（SUS）的协助下，这项全国性的回顾性队列研究旨在探索巴西RA患者心血管事件的分布，并确定与这些结果相关的因素。方法：年龄≥18岁的患者通过RA ICD-10代码从巴西统一卫生系统数据库（DATASUS）中识别，并根据SUS指南进行治疗。使用改善疾病的抗风湿药物（DMARDs）治疗的RA患者分为生物使用者和非生物（合成）使用者。分析心血管结局，包括急性冠状动脉疾病（ACAD）、心力衰竭和脑血管意外（CVA）。患者也根据治疗模式（转换或固定使用）进行分类。使用FIRJAN城市发展指数（IFDM）评估社会经济地位。描述性分析确定了人群分布和心血管结果，多元逻辑回归探讨了相关因素。采用的统计学意义为p < 0.05。结果：在4321例接受DMARDS治疗的RA患者中，确定了198例心血管结局（4.68%）。以女性为主（3398例[80.3%]），平均年龄54.2岁（标准差12.8），主要来自东南地区（2421例[57.2%]）。总体IFDM主要为bb0.8（47.5%）。高龄、心血管危险因素的存在以及合成dmard的使用与心血管结局相关。结论：类风湿性关节炎患者的心血管结局很常见，与年龄、合并症和治疗药物有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Arquivos brasileiros de cardiologia

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