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AB0356 Association between cardiovascular risk factors and carotid intima-media thickness in patients with rheumatoid arthritis
  1. R Mazarío González1,
  2. JJ Fragio Gil1,
  3. J Ivorra Cortes1,
  4. CM Feced Olmos1,
  5. FM Ortiz-Sanjuan1,
  6. E Grau Garcia1,
  7. E Sánchez Labrador1,
  8. S Barberá Huerta2,
  9. K Arévalo Ruales1,
  10. R Negueroles Albuixech1,
  11. I Martínez Cordellat1,
  12. I Chalmeta Verdejo1,
  13. L Gonzalez Puig1,
  14. C Alcañiz Escandell1,
  15. C Nájera Herranz1,
  16. I Cánovas Olmos1,
  17. E Vicens Bernabeu1,
  18. JE Oller Rodriguez1,
  19. V Fornés Ferrer3,
  20. JA Román Ivorra1,2
  1. 1Rheumatology Department, HUP la Fe
  2. 2Medical School, UCV
  3. 3Biostatistic Unit, IIS la Fe, Valencia, Spain

Abstract

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease which affects 0.5% of adults, especially women. This disorder is associated with increased morbidity and mortality due to atherosclerotic cardiovascular diseases. In addition to classical cardiovascular risk factors, inflammation plays a key role in this fact. Intima-media thickness (IMT) measured by carotid ultrasound is currently used to detect the presence of atherosclerotic disease and its value could be a predictor of subclinical cardiovascular disease.

Objectives To study cardiovascular risk factors, disease activity and carotid IMT in a RA patients series.

Methods Cross-sectional observational study of patients diagnosed with RA according to ACR/EULAR 2010 criteria. Patients with age under 75 years old and up of 5 years of disease evolution were included. Cardiovascular established disease patients were excluded. During a unique visit, patients underwent anamnesis, physical examination, laboratory test, electrocardiogram, chest X-ray and carotid ultrasound with Esaote-MyLabClassC equipment. Statistical analyses were performed using software R (version 3.3.2).

Results A total of 31 patients (57.1±9.7 years, 83.6% female, with 19.2±11.2 years of average disease course) were included. In relation to the classic cardiovascular risk factors, 19.4% were active smokers, 41.9% hypertensives and 45.2% had hypolipidemic treatment (85.7% with a statin), three of the patients were diabetic (9.7%). All patients were treated with monotherapy or combination therapy and 41.9% were also given glucocorticoid at low doses during the last 6 months. The median DAS28-VSG was 2.49 (1°Q=1.6; 3°Q=3.9), with an average HAQ of 0.88±0.68. As for extra-articular manifestations, 45.2% had xerophthalmia, 29% xerostomia, and 19.4% had rheumatoid nodules. The median total cholesterol was 195 mg/dL (174–221), and LDL of 116 mg/dL (96.5–138). The mean of the right carotid IMT was 576.13±118.78 mm and the carotid left IMT was 616.32±134.31 mm, resulting in 12 determinations higher values than expected to their age and sex provided by the ultrasound developer (38.7%). Using the SCORE table (modified by EULAR), only 5 patients (16.1%) had moderate-to -high cardiovascular risk. Statistical analysis showed a significative association between an increased IMT with tobacco consumption (classic cardiovascular risk factor) (p=0.028) and the modified SCORE (p=0.04). Neither years of evolution of disease nor the analytical biomarkers showed a significant association.

Conclusions Our study shows that in patients with good disease control data, classic cardiovascular risk factors are related to increased carotid intima-media thickness. However, these factors may underestimate overall cardiovascular risk over other measures of subclinical cardiovascular disease, such as carotid IMT.

Disclosure of Interest None declared

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