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THU0634 Sex Differences in Cardiovascular Risk Factors and Event Rates in Patients with Rheumatoid Arthritis - Data from 13 Rheumatology Centers
  1. S. Rollefstad1,
  2. E. Ikdahl1,
  3. C.S. Crowson2,
  4. S.E. Gabriel3,
  5. G.D. Kitas4,
  6. P.L. van Riel5,
  7. A.G. Semb1,
  8. on behalf of A Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis (ATACC-RA)
  1. 1Preventive Cardio-Rheuma Clinic, Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Division of Biomedical Statistics and Informatics, Department of Health Sciences Research and Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester
  3. 3Rutgers Robert Wood Johnson Medical School, New Brunswick, United States
  4. 4Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
  5. 5Department of Rheumatic Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands


Background In the general population it is well documented that females have their CVD diagnosed at a later stage compared to males. Wether this is true also for rheumatoid arthritis (RA) patients is not known.

Objectives To evaluate if cardiovascular disease (CVD) risk prediction and event rates differed between the sexes, and if adjustments for traditional and RA specific risk factors were of importance.

Methods RA cohorts from 13 rheumatology centers were compared. Data on CVD risk factors and RA characteristics were collected at baseline; CVD outcomes were collected using standardized definitions. Standardized incidence ratios (SIR) were calculated with respect to sex using the following risk calculators FRS, SCORE, ACC/AHA and QRISK II.

Results 5638 patients with RA and no prior CVD were included (mean age: 55.3 [SD: 14.0] years, 76% female). During a mean follow-up of 5.8 (SD: 4.4) years, 437 patients developed CVD events. SIRs (95% CI) using the various CVD risk calculators were for females and males: FRS: 1.02 (0.80, 1.31) and 0.86 (0.67, 1.12) (p=0.19), SCORE: 0.34 (0.17, 0.67) and 0.25 (0.11, 0.58) (p=0.98), ACC/AHA: 0.72 (0.50, 1.04) and 0.56 (0.36, 0.88) (p=0.74) and QRISKII 0.61 (0.47, 0.79) and 0.52 (0.35, 0.79) (p=0.42). The 10 year CVD-free survival differed significantly between the sexes, when adjusting for a) age, b) age and CVD risk factors and c) age, CVD risk factors and RA disease characteristics (Females [mean %±SD] 88.3±0.3, males 79.4±0.4), p<0.001 for all (Figure).

Conclusions In a large international cohort of patients with RA, there was no sex difference in the ability of the various risk calculators to predict CVD. CVD-free survival was significantly higher in females, even after adjustments for both traditional and RA specific risk factors.

Acknowledgement ATACC-RA collaborators: T.K. Kvien (Diakonhjemmet hospital, Oslo, Norway), E.L. Matteson (Mayo Clinic, Rochester, United States), K. Douglas and A. Sandoo (Dudley Group NHS Foundation Trust, West Midlands, United Kingdom), E. Arts and J. Fransen (Radboud University Medical Centre, Nijmegen, Netherlands), P.P. Sfikakis and E. Zampeli (University of Athens, Athens, Greece), S. Rantapää-Dahlqvist and S. Wållberg-Jonsson and L. Innala (University of Umeå, Umeå, Sweden), G. Karpouzas (Harbor UCLA Medical Center RHU, Torrance, United States), D. Solomon and K. Liao (Harvard Medical School Brigham and Women's Hospital, Boston, United States), M.A. Gonzalez-Gay and A. Corrales (Hospital Universitario Marques de Valdecilla, Santander (Cantabria), Spain), P.H. Dessein and L. Tsang (University of Witwatersrand, Johannesburg, South Africa), H. El-Gabalawy and C. Hitchon (University of Manitoba, Winnipeg, Manitoba, Canada), V.P. Ramos and I.C. Yáñez (Instituto Nacional de Ciencias Médicas y Nutriciόn Salvador Zubirán, México City, Mexico), M. van de Laar and H. Vonkeman and I. Meek (Hospital Medisch Spectrum Twente, Enschede, Netherlands), E. Husni and R. Overman (Cleveland Clinic, Cleveland, United States), I. Colunga and D. Galarza (Hospital Universitario “Dr. José E. González”, Monterrey, Mexico)

Disclosure of Interest None declared

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