Coronary Artery Disease in Adults with History of Juvenile Arthritis

OBJECTIVE:

To define the risk of coronary artery disease (CAD) in adults with a history of juvenile arthritis (JA) METHODS: We used the National Health and Nutrition Examination 2007-2014 Surveys. Two comparison groups were identified: 1) random sample without arthritis, and 2) respondents with reported rheumatoid arthritis (RA). Coronary artery disease was defined as “yes” to survey questions: “Have you ever been told you had congestive heart failure, coronary heart disease, angina/angina pectoris, heart attack, or stroke?” Potential confounders for CAD included age, gender, race, smoking status, and any component of metabolic syndrome.

RESULTS:

There were 232 respondents who reported JA; 1,028 randomly selected without arthritis; and 1,105 who reported RA. In simple logistic regression, the JA group had a three -fold increased odds of CAD compared to those without arthritis (odds ratio (OR): 3.2, 95% confidence interval (CI): 2.1-4.8, p<0.0001). Controlling for confounders, the odds of CAD in JA continued to be increased (OR: 4.2, 95% CI: 4.7-10.5, p=0.002). When comparing the JA and RA groups, in simple logistic regression, the JA group had a lower odds of CAD (OR 0.7, 95% CI: 0.5-0.9, p=0.03). Controlling for confounders, there was no significant difference in odds of CAD between groups (OR 0.8, 95% CI: 0.5-1.3, p=0.4).

CONCLUSION:

Adults with a history of JA have a higher risk of CAD compared to adults without arthritis. Providers should be aware of the increased risk of CAD in adults with juvenile arthritis and aggressively screen these patients for modifiable risk factors.

 2019 Oct 10. doi: 10.1002/acr.24087. [Epub ahead of print]