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Rheumatoid arthritis 'doubles thrombosis risk'

Patients with rheumatoid arthritis have double the risk of deep vein thrombosis or pulmonary embolism, suggests a new study.

The study

The ten-year nationwide prospective cohort study looked at the entire population of Taiwan (23.74m) and studied the association between rheumatoid arthritis, deep vein thrombosis (DVT) and pulmonary embolism. Some 29,238 patients had a diagnosis of rheumatoid arthritis and 1,16,952 controls were followed. The follow-up period extended to two years beyond the study. The researchers analysed the risks of DVT and pulmonary embolism, including sex, age and comorbidities.

The results

The risk of developing DVT was 3.36-fold greater and pulmonary embolism 2.07-fold greater in individuals with rheumatoid arthritis, compared with individuals without rheumatoid arthritis, after adjusting for age, sex and comorbidities. Rheumatoid arthritis had the greatest effect on developing DVT and pulmonary embolism in younger adults, compared with those without rheumatoid arthritis. The adjusted hazard ratio in those aged 50 years or younger with rheumatoid arthritis for DVT and pulmonary embolism was 5.55, 2.83 in middle-age adults (50 to 65 years) and 3.20 in older adults (65+ years), compared with those without rheumatoid arthritis. Regardless of the participants’ comorbidities, rheumatoid arthritis patients had a higher risk of DVT and pulmonary embolism than the comparison cohort.  

What this means for GPs

The researchers note that the findings highlight the ‘importance of a multi-disciplinary team adopting an integrated approach to intervention of potential risk factors among patients with rheumatoid arthritis’.

Ann Rheum Dis 2013, online 7 Aug

Readers' comments (1)

  • Vinci Ho

    Remember Virchow's triad ?
    RA is associated with vasculitis affecting the endothelial wall and plasma viscosity is increased by the presence of all the inflammatory cells . Hence , both arterial and venous thrombosis are increased in incidence.

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