Authors: Koivuniemi, R.¹; Paimela, L.²; Suomalainen, R.³; Piirainen, H.⁴; Karesoja, M.⁵; Helve, T.⁴; Leirisalo-Repo, M.⁴

Source: Rheumatology International, Volume 28, Number 12, October 2008 , pp. 1245-1252(8)

Publisher: Springer

Abstract:

We studied causes of death (CoDs) between 1952 and 1991 assessed by a clinician before autopsy and then determined at autopsy by a pathologist in 369 subjects with rheumatoid arthritis (RA) and 370 subjects without RA (non-RA). We analysed clinical data for RA subjects between 1973 and 1991. In RA subjects, leading autopsy-based CoDs were RA, cardiovascular diseases and infections. Between diagnoses of CoDs by the clinician and those determined by the pathologist, RA subjects had lower agreement than did the non-RA regarding coronary deaths (Kappa reliability measure: 0.33 vs. 0.46). In non-RA subjects, autopsy-based coronary deaths showed a decline since the 1970s with no such decline in RA. Between subjects treated at any time during RA with disease-modifying anti-rheumatic drugs and those without, autopsy-based CoDs were similar. Coronary death being less accurately diagnosed in RA subjects may indicate that coronary heart disease in RA patients often remains unrecognized.

Keywords: Rheumatoid arthritis; Cause of death; Autopsy

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00296-008-0685-6

Affiliations: 1: Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, PO BOX 263, 00029, HUS, Helsinki, Finland, Email: riitta.koivuniemi@hus.fi 2: Orton Hospital, Invalid Foundation, Tenholantie 10, 00281, Helsinki, Finland 3: Department of Pathology, Hyvinkää Hospital, Sairaalankatu 1, 05850, Hyvinkää, Finland 4: Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, PO BOX 263, 00029, HUS, Helsinki, Finland 5: Kivelä Municipal Hospital, PO BOX 6100, 00099, Helsingin kaupunki, Helsinki, Finland

Publication date: 2008-10-01

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