title: Risk for cardiovascular disease in Japanese patients with rheumatoid arthritis: a large-scale epidemiological study using a healthcare database.
abstract: OBJECTIVE
  To study risk for cardiovascular disease (CVD) in Japanese patients with rheumatoid arthritis (RA).
  
  
  METHODS
  We used a Medical Data Vision database mainly composed of health insurance claim data and diagnosis-procedure combination data from Japan. Patients with RA diagnosed from April 2011 to March 2014 at 71 hospitals were identified with the International Classification of Diseases 10th revision (ICD-10) and history of anti-RA drug prescription. Hospitalizations for CVD including ischemic heart disease, heart failure, and stroke were identified by a combination of diagnosis (ICD-10) and diagnostic procedures. CVD incidence rate ratio (IRR) for RA versus osteoarthritis was calculated. Risk factors were analyzed using univariate and multivariate Cox proportional hazard models with baseline C-reactive protein (CRP) and traditional risk factors as covariates.
  
  
  RESULTS
  We identified 8658 patients with RA. The age-sex adjusted IRR for RA versus osteoarthritis was high for total CVD [2.12; 95 % confidence interval (CI) 1.93-2.32], ischemic heart disease (2.16; 95 % CI 1.86-2.50), heart failure (2.34; 95 % CI 2.07-2.65), and stroke (1.68; 95 % CI 1.41-2.00). Risk factor analysis showed a tendency for cardiovascular risk to increase with higher baseline CRP, although the difference was not statistically significant (hazard ratio 1.43; 95 % CI 0.99-2.07).
  
  
  CONCLUSIONS
  Our study indicates an increased risk for CVD and an association between systemic inflammation and CVD in Japanese RA patients.
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hamada
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Terumi
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Akihide
authors.initials: A
authors.lastname: Atsumi
authors.affiliation: Clinical Development Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Shimura
authors.affiliation: Drug Safety Division, Chugai Pharmaceutical Co. Ltd., 1-1 Nihonbashi-Muromachi 2-Chome, Chuo-ku, Tokyo, 103-8324 Japan.
authors.forename: Masatomi
authors.initials: M
authors.lastname: Nemoto
keywords: Cardiovascular disease; Epidemiology; Healthcare database; Japanese; Rheumatoid arthritis