Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Statins and Risk of Acute Myocardial Infarction in Patients with RheumatoidArthritis: A Population-Based Study.
De Vera1, Mary, Lacaille1, Diane, Abrahamowicz2, Michal, Kopec1, Jacek A., Choi3, Hyon K.
Given their lipid lowering and anti-inflammatory properties, statins are postulated to have dual cardioprotective and anti-inflammatory benefits in rheumatoid arthritis (RA), a chronic arthritis associated with systemic inflammation and significant cardiovascular disease comorbidity. Our objective was to quantify the impact of statin initiation on risk of acute myocardial infarction (AMI) in a population-based cohort of RA patients.
We conducted a longitudinal study of statin initiators and non-initiators in a population-based cohort of RA patients followed from May 1996 to March 2006 using data from the British Columbia Ministry of Health. Utilization data for all provincially funded health services, including physician visits and hospitalizations, were obtained for all cohort members. We also obtained complete information on all prescription medications dispensed by pharmacists from January 1996 onwards, as well as mortality data from vital statistics, including date and cause of death. Non-fatal and fatal AMI outcomes were ascertained using hospitalization and Vital Statistics data. We applied propensity score methods to adjust for differences between statin initiators and non-initiators, and used Cox's proportional hazards models to evaluate the association between statin initiation and risk of AMI.
During 15,271 person-years of follow-up in the propensity-score matched cohort of 3,104 statin initiators and 3,104 non-initiators, we identified 261 AMI events (incidence rates, 1.5 and 2.1 per 100 person-years in initiators and non-initiators, respectively). After adjusting for confounding by indication, the hazard ratio (HR) for AMI for statin initiators compared to non-initiators was 0.69 (95% CI, 0.540.90). Additional adjustments including the propensity score (HR, 0.68; 95% CI, 0.530.88) or unbalanced covariates (HR, 0.68; 95% CI, 0.520.88) did not materially change results.
These population-based data indicate that statin use among RA patients is associated with a 31% lower risk of AMI. Findings provide evidence for a postulated cardioprotective role of statins in patients with RA.
To cite this abstract, please use the following information:
De Vera, Mary, Lacaille, Diane, Abrahamowicz, Michal, Kopec, Jacek A., Choi, Hyon K.; Statins and Risk of Acute Myocardial Infarction in Patients with RheumatoidArthritis: A Population-Based Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2577