THU0067

USE OF CARDIOVASCULAR DRUGS IN PATIENTS WITH RA, OVERALL AND IN PATIENTS WITH A HISTORY OF ACUTE ISCHEMIC CARDIAC EVENTS

M. Holmqvist ^1,*J. Eriksson ¹J. Askling ¹

¹Clinical epidemiology unit, Departement of Medicine, Solna, Karoliska University Hospital, Stockholm, Sweden

Background: Data on increased cardiovascular disease (CV) risks in RA are abundant. Less is known about the use of therapeutic or prophylactic CV management in RA. Some studies report a lower use of secondary prevention drugs following acute ischemic events in RA.

Objectives: To compare the use of selected classes of CV drugs distributions in RA and in the general population, overall and in subjects with a history of ischemic cardiac events.

Methods: From the Outpatient register, we identified a population-based prevalent RA-cohort consisting of all individuals with two or more visits listing RA in non-primary outpatient care 2005-2008, with at least one visit in 2009 (n=34,133). For each subject, five general population comparators were sampled (n=170,665). From the Prescribed Drug Register, all filled prescriptions of low-dose acetylsalicylic acid (ASA), statins, beta-blockers, ACE- and AII-inhibitors, diuretics, and calcium channel blockers (antihypertensives) during 2009 were retrieved. Information on hospitalizations for myocardial infarction or unstable angina within the last five years (2005-2009) was retrieved from the Hospital Discharge Register.

Results: Overall, the proportion of RA-patients and comparators treated with low-dose ASA (16%vs15%) and statins (19%vs20%) were similar but the proportion of patients treated with antihypertensives was higher (50%vs42%), similarly so across sex and age-groups (Table). 1,423 (4.2%) RA-patients and 4,063 (2.4%) comparators had a history of an acute ischemic cardiac event. Among these, the use of low-dose ASA (74%vs74%), at least one antihypertensive drug (96%vs96%) was similar, but use of statins was slightly less common in RA (75%vs80%). Among subjects without an acute ischemic cardiac event within 5 years, use of low-dose ASA (8%vs9%) and statins (11vs13% were largely similar but the proportion of RA treated with antihypertensives (42%vs35%) was higher.

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Conclusions: This preliminary analysis does not suggest any major difference in the use of secondary prophylaxis in RA with a history of ischemic cardiac events, but a slightly higher use of anti-hypertensive CV drugs in patients without a history of ischemic cardiac events. More detailed analyses will reveal whether this increased use reflects a met or unmet therapeutic need.

Disclosure of Interest: None Declared