Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Assessment of Cardiovascular Risk in Rheumatoid Arthritis. Impact of the New EULAR Recommendations.
Robustillo, Montserrat, Gomez-Vaquero, Carmen, Narvaez, Javier, Rodriguez-Moreno, Jesus, Estrada, Paula, Lopez-Vives, Laura, M. Nolla, Joan
Rheumatoid arthritis (RA) is a systemic inflammatory disease that is associated with an increased cardiovascular risk and a greater number of ischemic events than the general population.
To evaluate the cardiovascular risk and frequency of ischemic events in a group of patients diagnosed with RA.
Material and Methods:
We have included, consecutively, two hundred patients with rheumatoid arthritis diagnosed according to 1987 criteria of American College of Rheumatology (ACR), which are monitored regularly in the outpatient clinic of a tertiary care university hospital. We have reviewed retrospectively both the physical and the informatised medical record in the hospital and primary care and have gathered the following variables: a) age, sex, weight and height, b) duration of RA, c) parameters of activity of the disease, d) rheumatoid factor and anti-CCP, e) cardiovascular risk factors (smoking history, hypertension, hyperlipidemia, diabetes mellitus) and f) vascular ischemic events registered to date. From the age, sex, smoking history, arterial blood pressure levels and serum total cholesterol, we calculated the SCORE cardiovascular risk index (low-risk model). We calculated the SCORE cardiovascular risk index and we multiplied the result by 1.5 in patients who fulfilled the last EULAR recommendations (modified SCORE). The data were collected in an Access 2003 database and analyzed with the statistical software SPSS. Statistical significance was set at p <0.05.
The mean age of patients was 60 ± 12 years. 76% were women. The mean duration of RA was 12 ± 10 years. 82% were rheumatoid factor positive and 77%, positive anti-CCP. According to the DAS28, 51% of patients had a low activity, 39% moderate and 10% high. With regard to cardiovascular risk factors: 30% of patients were smokers or former smokers, 41% were diagnosed with hypertension, 52% were dyslipidemic and 12% had diabetes (2%, treated with insulin). The medium SCORE index (modified according to EULAR criteria) was 2.7 ± 2.9%, the change was indicated in 59% of patients. The cardiovascular risk calculated by SCORE correlated with classical vascular risk factors (age, male gender, smoking, hypertension and diabetes) and C-reactive protein. The modified SCORE is correlated also with positive RF and positive anti-CCP.
With regard to ischemic events, nine patients had had one or more: coronary (2 angina pectoris and 5 acute myocardial infarctions) or neurologic (two transient ischemic attacks and three strokes). Patients who had presented an ischemic event had higher age and higher modified SCORE than the other patients and they were more frequently male and smokers in a statistically significant way.
In patients with RA in our series, the incidence of cardiovascular risk factors and ischemic events is significant and is related to classical cardiovascular risk factors and C-reactive protein.
To cite this abstract, please use the following information:
Robustillo, Montserrat, Gomez-Vaquero, Carmen, Narvaez, Javier, Rodriguez-Moreno, Jesus, Estrada, Paula, Lopez-Vives, Laura, et al; Assessment of Cardiovascular Risk in Rheumatoid Arthritis. Impact of the New EULAR Recommendations. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1016