Objectives:
To investigate the associations between smoking status, smoking cessation and hospitalisations for cardiovascular events (CVE) and respiratory tract infections (RTI ) in an inception cohort of patients with rheumatoid arthritis (RA).
Methods:
The study was set within UK primary care electronic health records (the Clinical Practice Research Datalink) linked to hospital inpatient data (Hospital Episode Statistics). Patients with RA were followed from diagnosis to hospitalisation with a record of CVE or RTI , leaving their general practice, death, or 10 January 2012, whichever was earliest. Smoking status (never, current, former) was defined using primary care data and could vary over time. Survival analysis was performed using Cox regression (first event) and conditional risk set models (multiple RTI s).
Results:
5677 patients were included in the cohort: 68% female, median age 61 years. The age-adjusted and sexadjusted risks of hospitalisation for CVE or RTI were more than twice as high in current vs never smokers (CVE HR (95% CI) 2.19 (1.44 to 3.31); RTI 2.18 (1.71 to 2.78)). The risks for both outcomes were significantly higher in current compared with former smokers (CVE 1.51 (1.04 to 2.19), RTI 1.29 (1.04 to 1.61)). For each additional year of smoking cessation, the risk of first CVE and RTI hospitalisation fell significantly, approximately 25% and 15% respectively in the adjusted models.
Conclusions:
Patients with RA who smoke have an increased risk of hospitalisation with CVE or RTI compared with never and former smokers. The risk decreases for each additional year of smoking cessation. Patients with RA who smoke should be advised to stop smoking.
Rebecca M Joseph, Mohammad Movahedi, William G Dixon, Deborah PM Symmons, Risks of smoking and benefits of smoking cessation on hospitalisations for cardiovascular events and respiratory infection in patients with rheumatoid arthritis a retrospective cohort study using the Clinical Practice Research Datalink. RMD Open, 3(2), e000506, 2017.
Code | Description | Category | Coding System (ICD-10) | Entity type |
---|---|---|---|---|
I21 | Acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.0 | Acute transmural myocardial infarction of anterior wall | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.1 | Acute transmural myocardial infarction of inferior wall | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.2 | Acute transmural myocardial infarction of other sites | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.3 | Acute transmural myocardial infarction of unspecified site | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.4 | Acute subendocardial myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I21.9 | Acute myocardial infarction, unspecified | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I22 | Subsequent myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I22.0 | Subsequent myocardial infarction of anterior wall | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I22.1 | Subsequent myocardial infarction of inferior wall | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I22.8 | Subsequent myocardial infarction of other sites | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I22.9 | Subsequent myocardial infarction of unspecified site | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23 | Certain current complications following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.0 | Haemopericardium as current complication following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.1 | Atrial septal defect as current complication following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.2 | Ventricular septal defect as current complication following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.3 | Rupture of cardiac wall without haemopericardium as current complication following acute myocardial | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.4 | Rupture of chordae tendineae as current complication following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.5 | Rupture of papillary muscle as current complication following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.6 | Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute my | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I23.8 | Other current complications following acute myocardial infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63 | Cerebral infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.0 | Cerebral infarction due to thrombosis of precerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.1 | Cerebral infarction due to embolism of precerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.2 | Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.3 | Cerebral infarction due to thrombosis of cerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.4 | Cerebral infarction due to embolism of cerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.5 | Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.6 | Cerebral infarction due to cerebral venous thrombosis, nonpyogenic | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.8 | Other cerebral infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I63.9 | Cerebral infarction, unspecified | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I64 | Stroke, not specified as haemorrhage or infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
I64.0 | Stroke, not specified as haemorrhage or infarction | diagnostic | ICD-10 | res52: cardiovascular events ICD10 |
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1520 | Cardiovascular Events | ieuan.scanlon | 2021-10-26 | currently shown |
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