Rheumatoid arthritis linked to increased risk of out-of-hospital cardiac arrest among women

Out-of-hospital cardiac arrest (OHCA) tend to occur at a higher rate among patients with rheumatoid arthritis (RA), and this risk increase is especially pronounced in women but not observed in men, a study has found.

The study included 35,195 OHCA patients from presumed cardiac causes (case; median age 72 years, 66.8 percent male) and 351,950 individuals who did not experience OHCA (control). They were matched based on age, sex, and OHCA date to individuals.

Researchers applied Cox regression with time-dependent covariates to examine the association between RA and OHCA. They also performed stratified analyses according to sex and presence of cardiovascular diseases. Also, the association between OHCA and use of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with RA was studied.

The number of individuals with RA was 512 (1.45 percent) in the case group and 3,867 (1.10 percent) in the control group. RA contributed to a 22-percent increase in the rate of OHCA after controlling for cardiovascular comorbidities and use of QT-prolonging drugs (hazard ratio [HR], 1.22, 95 percent confidence interval [CI], 1.11–1.34).

On further analysis, the association between RA and OHCA was evident in women (HR, 1.32, 95 percent CI, 1.16–1.50) but not in men (HR, 1.12, 95 percent CI, 0.97–1.28; p_interaction=0.046).

The elevated OHCA rate associated with RA did not further increase in patients with cardiovascular disease. Finally, among patients with RA, use of NSAIDs was not associated with OHCA.

In light of the findings, the researchers highlighted the need for better management and early screening for cardiovascular risk factors in women with RA in order to prevent OHCA.