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Individuals living with chronic inflammatory diseases (CIDs) have an increased risk of coronary heart disease (CHD) and myocardial infarction (MI) ( 1, 2).
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Clinicians should personalize CHD risk and treatment based on type and severity of CID. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Ĭonclusions: Patients with SLE and SSc have a higher risk of CHD. Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). The multivariable-adjusted risk of CHD was significantly higher for SLE and SSc (HR 2.1, 95% CI 1.2, 3.9). Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. In secondary analyses, we compared CHD risk by disease severity within each CID. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD). However, sparse data exist regarding relative CHD risks across CIDs. 6Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United Statesīackground: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD).5Northwestern Medicine Enterprise Data Warehouse, Northwestern University, Chicago, IL, United States.4Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.3Institute for Public Health and Management, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.2Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.Pawlowski 5, Edward Thorp 6, Matthew DeBerge 6, Rosalind Ramsey-Goldman 1, Yvonne C.