Background Individual cardiovascular risk (CVR) in patients with inflammatory-rheumatic diseases can be estimated according to the SCORE-algorithm  and the EULAR recommendations for cardiovascular risk management .
Objectives To evaluate CVR in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) in daily practice and to relate this risk to the frequency of statin therapy.
Methods We studied 366 consecutive patients with RA and 101 patients with SpA from our university rheumatological outpatient department. The following data were collected: age (>40 years), gender, duration of disease, RF/CCP-antibody-status, lipid-status, blood pressure/use of antihypertensive drugs, comorbidities (diabetes mellitus, cardiovascular diseases), smoking, use of statins.
The 10-year-CVR was estimated according to the SCORE-algorithm  and the EULAR-recommendations . For patients with diabetes mellitus or established cardiovascular disease (coronary heart disease, peripheral or cerebrovascular arterial occlusive disease) an indication for statin use was postulated. In patient without these comorbidities, an indication for statin use was supposed in case of a 10-year-risk for cardiovascular events of at least 10 %.
Results Diabetes mellitus and/or a cardiovascular disease were comorbidities in 92 of 366 RA patients (25,1 %) and in 23 of 101 SpA-patients (22,8 %). From these patients 58 with RA (63 %) and 10 with SpA (43 %) were treated with statins.
In 274 RA- and 78 SpA-pts. without these comorbidities the assumed 10-year-risk for severe cardiovascular events according to the SCORE-algorithm accounted for:
- at least 10 % in 37 RA-pts. (13,5 %) and 9 SpA-pts. (11,5 %)
- between 5 and 10 % in 68 RA-pts. (24,8 %) and 13 SpA-pts. (16,7 %)
- under 5 % in 169 RA-pts. (61,7 %) and 56 SpA-pts. (71,8 %)
From 46 pts. with CVR of at least 10 % only 8 pts. (17,4 %) were treated with statins.
Conclusions In both RA- and SpA-patients diabetes mellitus or established cardiovascular diseases are common comorbidities, in these pts. statins are a common comedication. In contrast, in patients without these comorbidities but with high cardiovascular risk statins are only rarely used. Therefore, particularly patients over 60 years should be examined for the individual cardiovascular risk including reassessing the indication for statin use at least yearly. This requires a tight cooperation between rheumatologist and general practitioner.
Conroy et al.; Eur Heart J 2003;24:987–1003.
Peters et al.; Ann Rheum Dis 2010 69: 325-331.
Disclosure of Interest None Declared