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OP0209-HPR Incidence of first cardiovascular event in spanish patients with chronic inflammatory rheumatic diseases: prospective data from the carma project
  1. MA Martin Martinez1,
  2. S Castañeda2,
  3. C Gonzalez-Juanatey3,
  4. F Sanchez-Alonso1,
  5. S Marsal Barril4,
  6. M Romera-Baures5,
  7. J Santos-Rey6,
  8. JA Pinto-Tasende7,
  9. J Tornero-Molina8,
  10. R Lopez-Gonzalez9,
  11. MD Sanchez-Gonzalez10,
  12. J Llorca11,
  13. MA Gonzalez-Gay12
  1. 1Research of Unit of Spanish Society of Rheumatology
  2. 2Division of Rheumatology. Hospital Universitario la Princesa, Iis-Princesa, Madrid
  3. 3Division of Cardiology. Hospital Lucus Augusti, LUGO
  4. 4Division of Rheumatology. Hospital Universitario Vall D Hebron
  5. 5Division of Rheumatology. Hospital Universitario Bellvitge, Barcelona
  6. 6Division of Rheumatology. Hospital Virgen de la Salud, TOLEDO
  7. 7Division of Rheumatology. Complejo Hospitalario a Coruña, la Coruña
  8. 8Division of Rheumatology. Hospital Universitario de Guadalajara, Guadalajara
  9. 9Division of Rheumatology. Hospital Virgen de la Concha, ZAMORA
  10. 10Division of Rheumatolgy. Hospital Universitario de Salamanca, Salamanca
  11. 11Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Ciber Epidemiologia y Salud Publica (Ciberesp)
  12. 12Division of Rheumatology, Hospital Universitario Marques de Valdecilla, and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain

Abstract

Objectives To determine the incidence and risk factors implicated in the development of first cardiovascular event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD) attending rheumatology clinics after 2.5 years of follow-up.

Methods Analysis of data after 2.5 years of follow-up in an observational prospective study [CARdiovascular in rheuMAtology (CARMA) project] that includes a cohort of patients with CIRD [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)] and another cohort of matched individuals without CIRD attending outpatient rheumatology clinics from 67 hospitals in Spain. The cumulative incidence per 1000 patients and the incidence density per 1000 patient-months of non-fatal CVE were estimated in both cohorts at 2.5 years from the start of the project. Weibull proportional hazard model was used to calculate the Hazard Ratio (HR) and 95% confidence interval (95% CI) of the risk factors involved in the development of CVD events. Losses to follow-up and their causes were also analyzed.

Results The total number patient who completed the follow-up visit at 2.5 years was 2,598 (89.2% of those who started the study). Seven patients had died due to CVE and 23 because of non-CVE. The higher number of losses to follow-up was found in the control group (15.81%), because many of them were not periodically follow-up at the outpatient clinics. Cardiovascular cumulative incidence in patients with CIRD 15.30 cases per 1000 patients (95% CI: 12.93–17.67), being higher in AS patients 22.03 (95% CI: 11.01–33.04). The higher risk of developing a first CVE during the 2.5 years of follow-up was in patients with AS (HR: 4.11, 95% CI: 1.07–15.79; p: 0.04), those with older age (HR:1.09; 95% CI: 1.05–1.13, p<0.001), higher systolic blood pressure (HR: 1.02; 95% CI: 1.00–1.04, p=0, 01) and longer duration of the rheumatic disease (HR: 1.07; 95% CI: 1.03–1.12), p<0.01). In contrast, woman gender was a protective factor (HR: 0.43; 95% CI: 0.18–1.00, p=0.05).

Conclusions Patients with AS prospectively followed-up at rheumatology outpatients clinics show higher risk of developing a first CVE than those with RA or PsA. Besides traditional CVD risk factors a longer time course of the disease is a risk factor for the development of CVD in patients with CIRD.

Acknowledgements This project has been supported by an unrestricted grant from Abbvie, Spain. The design, analysis, interpretation of results and preparation of the manuscript has been done independently of Abbvie.

Disclosure of Interest None declared

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