A recent study has shown that the use of a combination of a tumor necrosis factor (TNF) inhibitor along with methotrexate therapy in people with rheumatoid arthritis (RA) was associated with a reduction in heart attack risk of 80 percent compared with patients using methotrexate alone, according to research presented recently at the American College of Rheumatology Annual Scientific Meeting in Boston, Mass.
Rheumatoid arthritis is a chronic, systemic, autoimmune disease that not only causes pain, stiffness, swelling, and limitation of function in joints, but also damages internal organs as well.
Approximately, 2.1 million Americans are afflicted with RA, most of them women. As mentioned above, while joints are the principal areas affected by RA, inflammation can develop in other organs as well. Heart attacks, resulting from inflammation of the coronary vessels, are more common in RA sufferers.
Researchers recently studied the risk of heart attack in patients using a TNF-inhibitor (a drug that blocks cytokines and can turn off the chronic inflammation that causes destruction in RA), methotrexate (a drug used to treat RA by blocking the metabolism of cells) and other disease modifying anti-rheumatic drugs (DMARDs), which are a category of drugs used in RA to slow down the disease progression, in a large population of patients with RA—many of whom were also taking aspirin.
Using information obtained from MediCal, California's Medicaid program, researchers studied patients over the age of 18, suffering from RA, who were treated with TNF-inhibitors, methotrexate, or other DMARDs, over a six-and-a-half year period.
A total of 19,233 patients with RA were identified. The patients' mean age was 55 years.
Approximately 79 percent were women. Of these patients, 13,383 took methotrexate; 14,958 took other DMARDS; and 4,943 took TNF-inhibitors. Exposure of one group of patients to TNF-inhibitors (taken alone or in combination with methotrexate) was compared to that of the other group taking methotrexate alone.
During the study period, 441 patients suffered heart attacks, of which eight percent were fatal.
Researchers found that patients on a combination of TNF-inhibitors with methotrexate treatment had a heart attack risk of only 20 percent of the risk compared to patients taking methotrexate alone.
However, there was no statistical difference seen among patients who were taking TNF-inhibitors alone, TNF-inhibitors with other DMARDs, other DMARD therapies without methotrexate, or a combination of DMARDs and methotrexate. Therefore, this reduction in cardiovascular events appears to be a function of the combination of methotrexate and TNF-inhibitors.
“TNF-inhibitor therapy, in combination with methotrexate, dramatically reduces the risk of heart attacks in patients with RA and should be seriously considered— especially in high-risk patients,” said Gurkirpal Singh, MD, clinical professor of medicine in the division of gastroenterology at Stanford University School of Medicine, and an investigator in the study.
The notion that RA is a potentially crippling disorder is widely accepted. However, what is not generally known is that it is a potentially lethal disease leading to an increased risk of heart attack and stroke.
It is imperative that patients with RA understand the systemic nature of this condition and the need for aggressive intervention. This study lends more ammunition to the argument that patients with RA need to be treated with a combination of methotrexate and biologic therapy to not only reduce the chances for crippling deformity but also to reduce the likelihood of cardiovascular death.
Treatment Of Heart Attack
Even with new medical procedures and breakthroughs in the
treatment and repair of a heart problem, heart attack cost has
skyrocketed beyond your wildest dreams. The cost associated with
a heart attack is not common knowledge, and until you enter the
game and get up close and personal, will you learn this is one
game you should have avoided.
Your first heart attack cost, most likely will be, general
ambulance service. Figure on at least $800-$1500 or more
depending on your location.
Your second heart attack cost will be ambulance medical support,
figure on an additional $100+.
Your third heart attack cost will be emergency room general
services at your local hospital. Figure on at least $750, then
professional fees for emergency room, another $250 or so. Then
tack on miscellaneous supplies, $500 for laboratory tests, about
$300 for EKG, plus X-ray drugs etc - for a grand total so far of
about $2500 for your emergency room visit.
Your fourth major heart attack cost will most likely be your stay
in the ICU of your local hospital, until they figure out what to
do with you. Figure on a day at a cost of about $850.
Now that you have the basic heart attack cost out of the way,
unless you live within reach of a major medical facility with a
heart specialist on staff, you are going to get a ride in a plane
or helicopter. Figure on an additional $5000-$6000 for this
opportunity.
Now we are getting to the real meat of our heart attack cost.
You have already spent about $10,000 or so getting to this point.
The next heart attack cost will make that seem like pocket
change!
You can figure on about $22,000-$25,000 for your stay in the
heart medical center, while they discover your heart problem and
try to repair your heart damage. And this does not include the
surgeons cost, which can add additional thousands to your overall
heart attack cost. So now your heart attack cost is over
$40,000. If everything goes well and your heart problem can be
corrected by Coronary Angioplasty, you are left with one
remaining heart attack cost, the chemical or treadmill stress
test. This could add as much as $5,000 more to your already
growing bill.
Your minimum heart attack cost for this overall experience will
be about $45,000-$50,000! If the Coronary Angioplasty procedure
cannot repair your damage and open heart surgery is needed, your
heart attack cost could more than double.
By choosing foods with lower fat and cholesterol content,
quitting smoking... if you do smoke, keeping your blood pressure
under control, and exercising regularly, you may avoid this
dangerous and costly experience... and eliminate heart attack
Both Nathan Wei & Brad Bahr are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Nathan Wei has sinced written about articles on various topics from Arthritis Pain, Health and Arthritis Signs. Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:. Nathan Wei's top article generates over 550000 views. Bookmark Nathan Wei to your Favourites.
Brad Bahr has sinced written about articles on various topics from Alternative Medicine, Arthritis Signs. Brad Bahr is the editor of many health related websites and publications.He has been testing and reviewing nutritional supplements for over 20 years. After trying hundreds of products, he recommends one supplement above all others for re. Brad Bahr's top article generates over 1300 views. Bookmark Brad Bahr to your Favourites.
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