Comparison of Incidence of Myocardial Infarction in Patients With Rheumatoid Arthritis and Diabetes Mellitus.
Level 3 - non-randomized controlled study
Prospective non-randomized cohort study with concurrent control groups
PubMed 34295575 · doi:10.7759/cureus.15716
What was done
A prospective cohort study enrolled 750 participants (1:1:1 ratio across three groups: rheumatoid arthritis, type 2 diabetes mellitus, and healthy controls; n=250 each) across two tertiary care hospitals in Pakistan. Patients were followed for 12 months or until the occurrence of a major adverse cardiovascular event to compare the incidence of myocardial infarction.
What was found
Rates of fatal MI (12.66% in RA vs. 13.48% in DM; p = 0.79) and non-fatal MI (3.93% in RA vs. 4.35% in DM; p = 0.82) did not differ significantly between the RA and DM cohorts. Compared to the control group, the RA group had a significantly higher rate of MI events (reported as 12.66% vs. 5.58%; p = 0.01).
Why it matters
These findings suggest that cardiovascular risk in rheumatoid arthritis is comparable in magnitude to that of type 2 diabetes, reinforcing the need for proactive cardiovascular screening and multidisciplinary management in RA patients.
Limits
The study had a short follow-up duration (12 months) and was limited to two centers in a single country. The abstract does not report confounding variable adjustments (such as baseline lipid levels, smoking, or medications like DMARDs and statins) and contains apparent internal discrepancies in the reported percentages for non-fatal MI.
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