Calcium Pyrophosphate Deposition Disease Is Linked to Cardiovascular Disease

Persons with calcium pyrophosphate deposition disease (CPPD) have a higher risk of major adverse cardiovascular events (MACE) and mortality than persons without CPPD, according to results of a new study presented at the 2019 American College of Rheumatology (ACR)/Association of Rheumatology Professionals (ARP) Annual Meeting.

To reach this conclusion, Maaman Bashir, MD, from the Medical College of Wisconsin, and colleagues utilized a Veterans Affairs database to conduct their retrospective study. To identify those with CPPD, the researchers searched for men who had one or more ICD-9 code for chondrocalcinosis or calcium metabolism disorder. The researchers identified 24,413 individuals with CPPD who were age- and sex-matched in a 1:4 ratio with 97,591 controls.

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To allow for covariate assessment, each participant had at least one health care encounter within the 365 days leading up to the index date, which was defined as the first ICD-9 code for CPPD or a matched date for controls. Covariates were included if they were present during the study period prior to MACE.

MACE was the primary outcome and was defined by ICD-9 and/or procedure codes for myocardial infarction (MI), acute coronary syndrome (ACS), revascularization, or ischemic stroke. The researchers also assessed for the secondary outcomes of individual types of MACE and all-cause mortality.

A total of 702 patients with CPPD (2.88%) and 1069 controls (1.10%) experienced a MACE.

The incidence rate (IR) of any MACE among patients with CPPD was nearly 3 times higher than controls (11.5 vs 4.3); the incidence rate ratio (IRR) was 2.66. The IRR for each type of MACE was also higher among those in the CPPD group compared with the control group.

The all-cause mortality rate was higher among patients in the CPPD group, with an IR of 57.7, compared with an IR of 42.9 among the control group. The IRR was 1.35.

In unadjusted survival analysis, CPPD patients had a shorter time to death than controls.

“CPPD was associated with an increased risk of MACE after adjusting for known cardiovascular disease risk factors,” the researchers concluded. “Patients with CPPD also had a higher mortality rate compared to patients without CPPD.”

—Colleen Murphy

Reference:

Bashir M, Sherman K, Tedeschi SK, Rosenthal A. Cardiovascular disease risk in calcium pyrophosphate deposition disease [abstract L04]. Arthritis Rheumatol. 2019;71 (suppl 10). Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. https://acrabstracts.org/abstract/cardiovascular-disease-risk-in-calcium-pyrophosphate-deposition-disease/. Accessed November 4, 2019.