All-Cause Mortality and Serious Cardiovascular Events in People with Hip and Knee Osteoarthritis: A Population Based Cohort StudyReportar como inadecuado




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Background

Because individuals with osteoarthritis OA avoid physical activities that exacerbate symptoms, potentially increasing risk for cardiovascular disease CVD and death, we assessed the relationship between OA disability and these outcomes.

Methods

In a population cohort aged 55+ years with at least moderately severe symptomatic hip and-or knee OA, OA disability Western Ontario McMaster Universities WOMAC OA scores; Health Assessment Questionnaire HAQ walking score; use of walking aids and other covariates were assessed by questionnaire. Survey data were linked to health administrative data to determine the relationship between baseline OA symptom severity to all-cause mortality and occurrence of a composite CVD outcome acute myocardial infarction, coronary revascularization, heart failure, stroke or transient ischemic attack over a median follow-up of 13.2 and 9.2 years, respectively.

Results

Of 2156 participants, 1,236 57.3% died and 822 38.1% experienced a CVD outcome during follow-up. Higher worse baseline WOMAC function scores and walking disability were independently associated with a higher all-cause mortality adjusted hazard ratio, aHR, per 10-point increase in WOMAC function score 1.04, 95% confidence interval, CI 1.01–1.07, p = 0.004; aHR per unit increase in HAQ walking score 1.30, 95% CI 1.22–1.39, p<0.001; and aHR for those using versus not using a walking aid 1.51, 95% CI 1.34–1.70, p<0.001. In survival analysis, censoring on death, risk of our composite CVD outcome was also significantly and independently associated with greater baseline walking disability aHR for use of a walking aid  = 1.27, 95% CI 1.10–1.47, p = 0.001; aHR per unit increase in HAQ walking score  = 1.17, 95% CI 1.08–1.27, p<0.001.

Conclusions

Among individuals with hip and-or knee OA, severity of OA disability was associated with a significant increase in all-cause mortality and serious CVD events after controlling for multiple confounders. Research is needed to elucidate modifiable mechanisms.



Autor: Gillian A. Hawker , Ruth Croxford, Arlene S. Bierman, Paula J. Harvey, Bheeshma Ravi, Ian Stanaitis, Lorraine L. Lipscombe

Fuente: http://plos.srce.hr/



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