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Coronary artery disease risk higher among adults with prior juvenile arthritis
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Adults with a history of juvenile arthritis carry a greater risk for coronary artery disease compared with those without arthritis, according to data published in Arthritis Care & Research.
“Coronary artery disease has been shown to be increased in adults with rheumatoid arthritis,” Sangeeta Sule, MD, PhD, of the Children’s National Health System and the George Washington University School of Medicine and Health Sciences, told Healio Rheumatology. “There are not much data about coronary artery disease in adults with a history of arthritis in childhood.”
“Using this large national database, we were able to show that the odds of coronary artery disease are increased in adults with childhood arthritis compared to adults with no history of arthritis,” she added. “This is important for providers to know because these adults with history of arthritis should be monitored closely for atherosclerosis and coronary artery disease.”
To analyze the risk for coronary artery disease among adults with a history of juvenile arthritis, Sule and Kevin Fontaine, PhD, of the University of Alabama at Birmingham, studied data from the CDC National health and Nutrition Examination Surveys (NHANES). Focusing on data from 2007 to 2014, the researchers identified 232 respondents who reported juvenile arthritis, as well as 1,028 respondents without any arthritis, pulled from a random sample and drawn in a 4:1 ratio to the juvenile arthritis group.
Juvenile arthritis was defined as an arthritis diagnosis at age 16 years or younger. The researchers also included a group of 1,105 respondents who reported having rheumatoid arthritis.
The primary outcome, coronary artery disease, was defined as a “yes” to the NHANES question, “Have you ever been told you had congestive heart failure, coronary heart disease, angina/angina pectoris, heart attack, or stroke?” Potential cofounders included age, gender, race, smoking status and any component of metabolic syndrome. The researchers conducted their analysis using Stata, version 15.1, and NHANES sample weights to account for the complex sampling design.
According to the researchers, a simple logistic regression determined that respondents who reported juvenile arthritis demonstrated a three-fold increased risk coronary artery disease, compared with those without arthritis (OR = 3.2; 95% CI, 2.1-4.8). After controlling for confounders, the risk for coronary artery disease among the juvenile arthritis group continued to increase (OR = 4.2; 95% CI, 4.710.5).
When comparing the juvenile arthritis and RA groups, a simple logistic regression found that the former had a lower risk for coronary artery disease (OR = 0.7; 95% CI, 0.5-0.9) than the latter. However, after controlling for confounders, there was no significant difference in the risks for either group.
“The key takeaways are to recognize that this population — adults with childhood arthritis — are at increased risk of heart disease just like adults with rheumatoid arthritis,” Sule said. “The clinical significance is that adults with childhood arthritis are at increased risk of coronary artery disease and should be screened for modifiable risk factors to reduce the risk of cardiac complications.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
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