Rheumatoid arthritis and risk of myocardial infarction: A nationwide cohort study

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ID: 320497
2026
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Abstract
Abstract Aims We investigated the risk of MI by RA status and seropositivity and performed exploratory analysis of biologic DMARD (bDMARD) and targeted synthetic DMARD (tsDMARD) use. Methods and results This retrospective cohort study used the Korean National Health Insurance System database. Patients aged ≥ 40 years newly diagnosed with RA (n = 36,377) were matched 1:3 with non-RA controls (n = 109,131). Fine and Gray subdistribution hazard models estimated subdistribution hazard ratios (sHR) for MI risk by RA status, seropositivity, bDMARD, and tsDMARD use. During a mean follow-up of 5.6 ± 2.3 years, 1201 MI events in non-RA, 738 in RA, 186 in seronegative RA (SNRA), 552 in seropositive RA (SPRA), 64 with bDMARD use, and 4 with tsDMARD use were identified. Patients with RA had a 1.8-fold increased MI risk compared to non-RA (sHR: 1.84, 95% CI: 1.67–2.01). SNRA and SPRA showed similar risks (sHR: 1.74, 95% CI: 1.49–2.04, and sHR: 1.87, 95% CI: 1.69–2.07, respectively). MI risk remained elevated both with and without bDMARD use (sHR: 2.34, 95% CI: 2.05–2.67; sHR: 1.81, 95% CI: 1.72–1.91, respectively). Non-use of tsDMARDs was associated with increased MI risk (sHR: 1.86, 95% CI: 1.77–1.96), whereas tsDMARD use was not significantly associated with MI (sHR: 1.43, 95% CI: 0.90–2.28). Conclusions RA was associated with increased MI risk irrespective of seropositivity status. Exploratory analyses suggested that tsDMARD users did not exhibit increased MI risk, although the small number of events warrants large-scale prospective studies.
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openalex_W7167914250 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors In Young Cho, Jin Hyung Jung, Seonyoung Kang, S.P. Kim, Wonyoung Jung, Alicia Shin, Hyungjin Kim, Kyungdo Han, Dong Wook Shin
Journal european journal of preventive cardiology
Year 2026
DOI
10.1093/eurjpc/zwag358
URL
https://doi.org/10.1093/eurjpc/zwag358
Keywords Keywords not found

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