Cardiovascular pathology in the structure of comorbidity and mortality of patients with rheumatoid arthritis

Abstract

Relevance. Obtaining reliable data on the levels of cardiovascular morbidity and mortality among patients with rheumatoid arthritis remains important. These aspects of patient management are very important; they determine further therapeutic tactics and are aimed at reducing the risks of complications. Target — to analyze cardiovascular pathology in the structure of comorbidity and mortality of patients with RA in the cohort of patients of the Center for Responsible Rheumatology ″Induction″ LLC in the period 2015–2022. Materials and Methods. A sample of 1020 patients with a reliable diagnosis of RA, established according to the classification criteria (ACR/EULAR, 2010), who were treated at the LLC Center for Responsible Rheumatology ″Induction″, was made. The average age was 55.3 ± 1.8 years, women predominated (88.8%). Comorbid status was assessed on the basis of lifetime consultations and analysis of medical documentation of the examined patients according to a developed chart, including a specified cardiovascular disease, as well as the fact of death. A systematic review of scientific works (2019–2024) on rheumatoid arthritis in the aspect of cardiovascular pathology was carried out. Results and Discussion. The incidence of cardiovascular pathologies in patients with RA, according to numerous studies (2019–2024), varies widely. Hypertension, coronary artery disease, heart failure, cardiac rhythm and conduction disorders, and atherosclerotic cardiovascular diseases occupy the leading place in prevalence. Patients with RA in the study cohort were characterized by a complex comorbidity structure. Cardiovascular pathology is the most common (42.29%). Respiratory diseases (23.07%), COVID-19 (11.53%), and Blastomatosis (7.69%) follow it. Acute pancreatitis complicated by pancreatic necrosis, bronchial asthma, lymphocytic leukemia, hypothyroidism, autoimmune thyroiditis, diabetes mellitus were recorded in no more than 3.85% of the cohort. Cardiovascular disorders included ischemic heart disease (30.76%) and hypertension (11.53%). The three main causes of death in patients with RA included cardiovascular, respiratory diseases, and sepsis. The leading position was occupied by cardiovascular events (47.83%), predominantly acute myocardial infarction (30.43%). Conclusion. An analysis of new data on the place of cardiovascular diseases in the structure of comorbidity and mortality of patients in the Stavropol Territory of the LLC “Center for Responsible Rheumatology ″Induction″ cohort with an established diagnosis of RA was carried out. The information obtained is useful for a better understanding of the clinical portrait of RA patients with cardiovascular pathology, and can be taken into account by rheumatologists to optimize management tactics for RA and the risk of cardiovascular events.