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AB0259 Characteristics and cardiovascular comorbidities in patients with rheumatoid arthritis in a local patient cohort in russia
  1. T. A. Panafidina1,
  2. L. V. Kondratyeva1,
  3. E. V. Gerasimova1,
  4. Y. N. Gorbunova1,
  5. T. V. Popkova1,
  6. E. L. Nasonov1
  1. 1Research Institute of Rheumatology of the Russian Academy of Medical Sciences, Moscow, Russian Federation

Abstract

Background Patients with Rheumatoid Arthritis (RA) have an increased risk for cardiovascular disease (CVD).

Objectives To evaluate CVD prevalence and RA-related factors in RA patients participating in the prospective longitudinal (7 years duration) observational study. After the initial baseline visit, data will be collected every 6 months using the physician and patient questionnaires.

Methods We studied 200 patients in a cross-sectional fashion: 165 (82,5%) females and 35 (17,5%) males, median (Me) age 55 [interquartile range (IR) 46;61] years who meet the 1987 ARA revised criteria for the classification of RA and enrolled in our cohort. Exclusion criteria: age less than 18 years or greater than 85 years at the time of enrollment into the registry, ACR functional class 4 RA. We considered the CVD (cardiovascular heart disease, cardiovascular revascularization procedure, myocardial infarction and stroke), traditional cardiovascular risk factors (smoking, family history of CVD, hypertension, dyslipidemia, menopausal status, body mass index (BMI), diabetes mellitus) and RA-related factors (duration of RA, disease activity score (DAS 28), seropositivity for IgM rheumatoid factor (RF) and antibodies against cyclic citrullinated peptides (ACCP), ACR functional class, treatment including both biologic and non-biologic disease modifying anti-rheumatic drugs (DMARDs) and steroids).

Results The median disease duration of RA was 5 [1;10] years, early RA (≤ 1 year) was diagnosed in 60/200 (30%) patients, DAS 28 score was 3,9 [3,1;4,9], seropositive for IgM RF – 166/200 (83%) and/or ACCP – 151/200 (75,5%), 133/188 (73%) patients had erosions, ACR functional class I RA was 46/200 (23%), II RA – 129/200 (64,5), III RA – 25/200 (12,5%). Therapy: 87/200 (43,5%) patients received oral glucocorticoids, 141/200 (70,5%) – methotrexate, 18/200 (9%) – leflunomide, 6/200 (3%) – hydroxychloroquine, 2/200 (1%) – azathioprine, 43/200 (21,5%) - biologic DMARDs: rituximab – 13/200 (6,5%), adalimumab – 12/200 (6%), abatacept – 9/200 (6%), certolizumab pegol – 4/200 (2%), infliximab – 3/200 (1,5%), tocilizumab – 2/200 (1%).

Ischemic heart disease was diagnosed in 38/200 (19%) patients, myocardial infarction – 3/200 (1,5%), cardiovascular revascularization procedure (coronary artery bypass graft) – 7/200 (3,5%), and stroke – 1/200 (0,5%). We observed the following frequency of traditional CVD risk factors: CVD family history – 58/200 (29%), dyslipidemia – 91/200 (46 %), BMI≥25 – 117/200 (58,5%), hypertension – 120/200 (60%), diabetes mellitus – 14/200 (7%), smoking status (ex-smoker+smoker) – 88/200 (44%), menopause – 110/165 (55%).

Conclusions RA patients had a high frequency of CVD (20%). Ongoing observation of this cohort will further assess to assess the impact of chronic inflammation and specific therapy on CVD.

Disclosure of Interest None Declared

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