Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Cardiovascular risks and primary interventions among treated rheumatoid arthritis patients: Experience from a tertiary care centre in Kuala Lumpur, Malaysia

Shantini Radhakrishnan¹, Salmi Abdul Razak¹, Mohd Shahrir Bin Mohamed Said², Noraida Mohamed Shah¹, Adyani Md Redzuan¹

¹Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia; ²Medical Department, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.

For correspondence:- Adyani Redzuan Email: adyani@ukm.edu.my Tel:+60392897264

Accepted: 6 March 2022 Published: 30 April 2022

Citation: Radhakrishnan S, Razak SA, Said MS, Shah NM, Redzuan AM. Cardiovascular risks and primary interventions among treated rheumatoid arthritis patients: Experience from a tertiary care centre in Kuala Lumpur, Malaysia. Trop J Pharm Res 2022; 21(4):863-869 doi: 10.4314/tjpr.v21i4.25

© 2022 The authors.
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Abstract

Purpose: To investigate the cardiovascular risk among treated rheumatoid arthritis (RA) patients to predict the factors associated with high cardiovascular risk and to determine the presence of pharmacotherapy primary prevention among treated RA patients with high cardiovascular disease (CVD) risk.

Methods: The study was a prospective cross-sectional study on adult patients diagnosed and treated for RA and without established heart disease/stroke. Cardiovascular risk scoring was based on Framingham Cardiovascular Disease 10-year risk prediction model (BMI model) x 1.5 factor while descriptive and inferential analyses were done using SPSS.

Results: High CVD risk was defined as FRS-CVD cardiovascular risk categories (>20%) and 55.9% of patients were at high CVD risk. Use of Hydroxychloroquine (OR: 0.44; 95 % CI: 0.21- 0.92; p= 0.028) and COX-2 inhibitors (OR: 0.31; 95% CI:0.10- 0.95; p = 0.039) were found to be significantly associated with high CVD risk among treated RA patients. Significant number of high CVD risk patients did receive pharmacotherapy primary prevention (p = 0.001).

Conclusion: Hydroxychloroquine and COX-2 inhibitors are independent negative risk predictors associated with high CVD risk among treated RA patients. Baseline cardiovascular risk data may be useful in rational use of medications to treat RA, considering that cardiovascular related mortality is the leading cause of death in RA.

Keywords: Cardiovascular risk, Rheumatoid Arthritis, primary prevention, high CVD risk