Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis. Results from a primary care-based incident case-control study in Norfolk, England

Background:Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor.Objectives:To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors.Methods:A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors).Results:A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p<0.001).Table 1.Table 2.RA basal characteristicsDisease duration (years)16,98 (11,38)Erosions (X-Ray of hands/feet)163 (81,5%)Seropositive (RF/anti-CCP)146 (73%)Extra-articular symptoms44 (22%)Intersticial difusse lung disease10 (5%)Rheumatoid nodules14 (7%)Prednisone use103 (51,5%)Median dose of Prednisone last year (mg)2,34 (2,84)sDMARDsMethotrexate104 (52%)Leflunomide29 (14,5%)Hydroxycloroquine9 (4,5%)bDMARDs89 (44,5%) TNFi41 (20,5%) Abatacept15 (7,5%) IL6i22 (11%) RTX11 (5,5%)JAKi26 (13%) Baricitinib11 (5,5%) Tofacitinib15 (7,5%)DAS 28-ESR3,1 (2,3, 3,9)SDAI7,85 (4,04, 13,41)HAQ0,88 (0,22, 1,5)RF (U/mL)51 (15, 164,25)Anti-CCP (U/mL)173 (22, 340)Patients showed higher intima-media (both right and left) thickness compared to controls (p<0.006). Moreover it was also related to the disease duration and DAS28 score (p<0.001). A higher plaque account was noted in cases(p<0.004) and it was also related to the disease duration (p<0.001).Conclusion:RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor.Disclosure of Interests:None declared

Download Full-text

Risk Factors for Methotrexate-Induced Lung Injury in Patients with Rheumatoid Arthritis: A Multicenter, Case-Control Study

Annals of Internal Medicine ◽

10.7326/0003-4819-127-5-199709010-00003 ◽

1997 ◽

Vol 127 (5) ◽

pp. 356 ◽

Cited By ~ 193

Author(s):

Graciela S. Alarcon

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Lung Injury ◽

Case Control Study ◽

Case Control ◽

Control Study

Download Full-text

EVALUATION OF RISK FACTORS AFFECTING ANASTOMOTIC LEAKAGE AFTER REPAIR OF ESOPHAGEAL ATRESIA

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202015000300003 ◽

2015 ◽

Vol 28 (3) ◽

pp. 161-162 ◽

Cited By ~ 4

Author(s):

Shahnam ASKARPOUR ◽

Mehran PEYVASTEH ◽

Hazhir JAVAHERIZADEH ◽

Nasim ASKARI

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Anastomotic Leakage ◽

Anastomotic Leak ◽

Esophageal Atresia ◽

Case Control Study ◽

Case Control ◽

Anastomotic Leaks ◽

Factors Affecting ◽

Control Study

Background: Anastomotic leak are reported among neonates who underwent esophageal atresia. Aim: To find risk factors of anastomotic leakage in patients underwent esophageal repair. Methods: All cases with esophageal atresia were included. In this case control study, patients were classified in two groups according to presence or absence of anastomotic leaks. Duration of study was 10 years. Results: Sixty-one cases were included. Mean±SD age at time of surgery in patients with leakage and without leakage was 9.50±7.25 and 8.83±6.93 respectively (p=.670). Blood transfusion and two layer anastomosis had significant correlation with anastomotic leakage. Conclusion: Blood transfusion and double layer anastomosis are associated with higher rate of anastomotic leakage.

Download Full-text

Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent Region (UK)

Epidemiology and Infection ◽

10.1017/s0950268800051293 ◽

1994 ◽

Vol 112 (3) ◽

pp. 595-601 ◽

Cited By ~ 41

Author(s):

K. R. Neal ◽

D. A. Jones ◽

D. Killey ◽

V. James

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Blood Transfusion ◽

Blood Donors ◽

Case Control Study ◽

Case Control ◽

Hcv Infection ◽

History Of ◽

Control Study

SUMMARYThe introduction of screening for hepatitis C virus (HCV) by the National Blood Transfusion Service identified donors who had acquired HCV infection. We undertook a case-control study amongst blood donors in the Trent Region to determine risks for HCV infection. A total of 74 blood donors confirmed positive for hepatitis C infection and 150 age, sex and donor venue matched controls were included in the study. Fifty-three percent of hepatitis C infected blood donors reported previous use of injected drugs compared to no controls; relative risk (RR) not estimatable (lower limit 95% CI = 20). Other risk factors were a history of: receipt of a blood transfusion or blood products RR = 3·6 (95% CI 1·5–8·3), having been a ‘health care worker’ RR = 2·8 (95% CI 1·1–7·6), tattooing RR = 3·3 (95% CI 1·2–8·7), and an association with having been born abroad RR = 3·2 (95% CI 1·1–9·5). No risk was shown for a history of multiple sexual partners, ear piercing or acupuncture. Injecting drug use explains more than 50% of hepatitis C infections in blood donors, a group who are less likely to have injected drugs than the general population.

Download Full-text