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THU0164 Subclinical atherosclerosis and cardiovascular events in italian patients with rheumatoid arthritis: results from multicenter girrcs (gruppo italiano di ricerca in reumatologia clinica e sperimentale) study
  1. P Ruscitti1,
  2. DPE Margiotta2,
  3. L Navarini2,
  4. F Macaluso3,
  5. D Iacono4,
  6. F D'Onofrio5,
  7. G Emmi6,
  8. F Atzeni7,
  9. M Prete8,
  10. F Perosa8,
  11. P Sarzi-Puttini7,
  12. L Emmi6,
  13. FP Cantatore5,
  14. G Triolo3,
  15. R Giacomelli1,
  16. G Valentini4
  1. 1Rheumatology Section, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila
  2. 2Clinical Medicine and Rheumatology Department, Campus Bio-Medico University of Rome, Rome
  3. 3Rheumatology Section, Department of Internal Medicine, University of Palermo, Palermo
  4. 4Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples
  5. 5Rheumatology Section, Department of Medical and Surgical Sciences, University of Foggia Medical School, Foggia
  6. 6Department of Experimental and Clinical Medicine, University of Florence, Florence
  7. 7Rheumatology Section, L. Sacco University Hospital, Milan
  8. 8Systemic Rheumatic and Autoimmune Diseases Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy

Abstract

Background Several studies showed a close relationship between Rheumatoid Arthritis (RA) and accelerated atherosclerosis [1,2]. At the best of our knowledge, no such study has been carried out in a large Italian series.

Objectives To investigate the prevalence of presence of subclinical atherosclerosis and history of cardio-cerebrovascular events (CVEs), in 1266 patients consecutively admitted to Rheumatology Units throughout the whole Italy.

Methods From 01/01/2015 to 31/12/2015, 1266 consecutive patients admitted to GIRRCS centres, satisfying ACR/EULAR criteria for RA were investigated for: i. traditional cardiovascular risk factors: gender, age, smoking habit, cholesterol, triglycerides, glycemia, systemic arterial hypertension (SAH), metabolic syndrome (MS), type 2 diabetes (T2D); ii. RA aspects: disease duration as assessed from the first symptom, disease activity as evaluated by DAS28, radiographic damage by joint X-ray, and joint surgery; iii. subclinical atherosclerosis, as assessed by ultrasound technique and/or atherosclerotic peripheral lesions; iv. history of CVEs.

Results We evaluated 1176 patients out of 1266, that were investigated for both CVEs and subclinical atherosclerosis. They were mostly females (80.52%), with a median age of 60 years (range 18–91 years), a median disease duration of 12 years (range 0.8–25 years), seropositive in 69.21%. Nineteen percent were in remission; 17.51% presented low disease activity; 39.45% moderate disease activity, 22.61% high disease activity.

Out of 1176 patients, 217 (18%) showed evidence of subclinical atherosclerosis: a figure lower than that reported worldwide (32.7%) [2]. Eighty-two patients (6.9%) had a history for CVEs (58 myocardial infarction, 38 heart failure, 10 ischemic transitory attack, 7 Stroke), too this figure is lower than that reported worldwide (8.5%) [3,4]. In multivariate analysis, older age (p=0.0001, OR:1.069, CI95%:1.05–1.09), MS (p=0.0001, OR:3.417, CI95%:2.16–5.40) and SAH (p=0.0001, OR:3.714, CI95%:2.23–6.17) and high disease activity (p=0.001, OR:2.117, CI95%:1.35–3.32) were significantly associated with the presence of subclinical atherosclerosis. Male gender (p=0.0001, OR:3.465, CI95%:1.94–6.185), MS (p=0.005, OR:2.542, CI95%:1.29–4.52), T2D (p=0.007, OR:2.324, CI95%:1.29–4.29) and SAH (p=0.001, OR:4.921, CI95%:2.14–11.45) and higher disease activity (p=0.003, OR:1.316, CI95%:1.15–1.68) were significantly associated with a history of CVEs.

Conclusions This is the first Italian multicenter study on subclinical and clinical atherosclerosis in patients with RA. We pointed out a low prevalence of both subclinical atherosclerosis and history of CV events. Nonetheless, a high disease activity and presence of cardiovascular risk factors were found to play a role, similarly to other countries.

References

  1. Ruscitti P, et al. PLoS One. 2017;12:e0170108.

  2. Ambrosino P, et al. Thromb Haemost. 2015;113:916–30.

  3. Solomon D et al. Ann Rheum Dis. 2010;69:1920–5.

  4. Avina-Zubieta JA, et al. Ann Rheum Dis. 2012;71:1524–9.

References

Disclosure of Interest None declared

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