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AB1215-HPR Cardiovascular Risk Assessment in a Sample of Patients with Spondyloarthritis
  1. R. Rey Villar,
  2. E. Alonso Blanco-Morales,
  3. J.M. Bravo-Ferrer Acosta,
  4. E. Gismero Salmador,
  5. A. Soilan Lopez,
  6. N. Martinez Fernandez,
  7. J.A. Pinto Tasende,
  8. F.J. Blanco García
  1. Rheumatology, University Hospital A Coruña, A Coruña, Spain

Abstract

Background Cardiovascular diseases are, in our country, the leading cause of death and hospitalization in adults. Besides cardiovascular risk in patients with spondyloarthritis (SpA) is increasing by the mere fact of suffering from the disease (1).

Objectives

  • Measurement of cardiovascular risk in patients with SpA (ankylosing spondylitis and psoriatic arthritis).

  • Determine the Ankle-brachial Index (ABI) of patients who meet the screening criteria, according to the American Heart Association (2).

Methods Descriptive prospective observational study in a tertiary level hospital. From April 2014, all the patients in the SpA follow up cohort, who were attended consecutively in rheumatology medical consultations were selected, signing the informed consent.

A personal interview was performed to determine cardiovascular risk evaluated with SCORE tables calibrated for Spain, Classic Framingham and REGICOR.

Of all patients, those who met the criteria of the American Heart Association for the determination ABI were selected: Subjects with more than 50 years and those under 50 with diabetes and other risk factors or more than 10 years of evolution.

Statistical analysis was performed using SPSS v.19.

Results The average age was 49 years (±14.07), with 66% male and 58% diagnosed with Psoriatic Arthritis according CASPAR criteria. 42.8% of patients were treated with biologic therapy and 30% with anti-inflammatory request. The prevalence of diabetes was 8%, hypertension 32% and 28% smoking. 26% had cholesterol above 200mg/dl. 75% of patients had obesity or overweight, diagnosis of metabolic syndrome 23.3% and waist circumference increase of 32%.

22.2% of over 60s had a pulse pressure (PP) greater than 65mmHg, a risk marker in elderly population (3), which may be useful for the assessment of individual cardiovascular risk.

Of the patients who underwent the ABI, 21.7% (5) obtained an ABI <0.9 pathological, with an average 1.12±0.18, and the range between 0.77 and 1.29. The minimum age was 58 years, all had obesity or were overweight, had an increased waist circumference, hypertension, PP>65 mmHg, Score>4% and the number of lowest total cholesterol was 187mg/dl.

Conclusions Only 4% of the patients do not present any risk factor, so this is a sample of patients highly suitable to perform a nurse led care preventive intervention aimed at improving the lifestyle of patients and thus the symptoms of the disease and treatment adherence.

References

  1. Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum. 2004;34(3):585-92.

  2. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, JL. H, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abominal aortic): a collaborative report. 2006. p. 463-54.

  3. Villa Estebanez R, Tranche Iparraguirre S, Marin Iranzo R, Prieto Diaz MA, Hevia Rodriguez E. [Pulse pressure as a marker of cardiovascular risk among the elderly]. Aten Primaria. 2002;30(6):374-80.

Disclosure of Interest None declared

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