Risk of Venous Thromboembolism in Patients With Rheumatoid Arthritis and Association With Disease Duration and Hospitalization

• Published in: JAMA : the journal of the American Medical Association 2012-10, Vol.308 (13), p.1350-1356
• Main Authors: Holmqvist, Marie E, Neovius, Martin, Eriksson, Jonas, Mantel, Ängla, Wållberg-Jonsson, Solveig, Jacobsson, Lennart T. H, Askling, Johan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Age of Onset; Aged; Aged, 80 and over; Annan klinisk medicin; Arthritis; Arthritis, Rheumatoid - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Blood clots; Cardiology. Vascular system; Case-Control Studies; Clinical Medicine; Diseases of the osteoarticular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; General aspects; Hospitalization; Hospitalization - statistics & numerical data; Humans; Inflammatory diseases; Inflammatory joint diseases; Klinisk medicin; Length of Stay; Male; Medical and Health Sciences; Medical research; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Other Clinical Medicine; Prospective Studies; Rheumatoid Factor - blood; Risk; Sex Factors; Sweden - epidemiology; Venous Thromboembolism - epidemiology; Young Adult
• ISSN: 0098-7484; 1538-3598; 1538-3598
• DOI: 10.1001/2012.jama.11741

CONTEXT Recent reports suggest that rheumatoid arthritis (RA) may be a risk factor for venous thromboembolism (VTE), particularly in conjunction with hospitalization. Using hospitalization data to identify RA and VTE may identify patients when they are at elevated risk for other reasons, obscuring the incompletely understood underlying association between RA and VTE and leading to inappropriate institution or timing of interventions. OBJECTIVE To estimate risks for VTE in patients with RA, including the relation of these risks to disease duration and hospitalization. DESIGN, SETTING, AND PATIENTS Prospective, population-based cohort study of 1 prevalent RA cohort (n = 37 856), 1 incident RA cohort (n = 7904), and matched general population comparison cohorts, all from Sweden, with follow-up from 1997 through 2010. MAIN OUTCOME MEASURE First-time VTE. RESULTS Patients with prevalent RA were at greater risk of VTE than the general population (rate, 5.9 [95% CI, 5.1-6.6] vs 2.8 [95% CI, 2.6-3.1] per 1000 person-years (adjusted hazard ratio [HR], 2.0 [95% CI, 1.9-2.2]; P