Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk
Abstract Background Previous studies have shown that risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the actual cardiovascular (CV) risk of patients with rheumatoid arthritis (RA). In contrast, carotid ultrasound was found to be useful to identify...
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doaj-6922daf70bba47de8fc697de403b11682021-06-06T11:53:02ZengBMCArthritis Research & Therapy1478-63622021-06-0123111010.1186/s13075-021-02542-7Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular riskIván Ferraz-Amaro0Alfonso Corrales1Juan Carlos Quevedo-Abeledo2Nuria Vegas-Revenga3Ricardo Blanco4Virginia Portilla5Belén Atienza-Mateo6Miguel Á. González-Gay7Division of Rheumatology, Hospital Universitario de CanariasEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALDivision of Rheumatology, Hospital Doctor NegrínEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALEpidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, IDIVALAbstract Background Previous studies have shown that risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the actual cardiovascular (CV) risk of patients with rheumatoid arthritis (RA). In contrast, carotid ultrasound was found to be useful to identify RA patients at high CV. In the present study, we aimed to determine if specific disease features influence the CV risk reclassification of RA patients assessed by SCORE risk charts and carotid ultrasound. Methods 1279 RA patients without previous CV events, diabetes, or chronic kidney disease were studied. Disease characteristics including disease activity scores, CV comorbidity, SCORE calculation, and the presence of carotid plaque by carotid ultrasound were assessed. A multivariable regression analysis was performed to evaluate if the reclassification into very high CV risk category was independently associated with specific features of the disease including disease activity. Additionally, a prediction model for reclassification was constructed in RA patients. Results After carotid ultrasound assessments, 54% of the patients had carotid plaque and consequently fulfilled definition for very high CV risk. Disease activity was statistically significantly associated with reclassification after fully multivariable analysis. A predictive model containing the presence of dyslipidemia and hypertension, an age exceeding 54 years, and a DAS28-ESR score equal or higher than 2.6 yielded the highest discrimination for reclassification. Conclusion Reclassification into very high CV risk after carotid ultrasound assessment occurs in more than the half of patients with RA. This reclassification can be independently explained by the activity of the disease.https://doi.org/10.1186/s13075-021-02542-7Rheumatoid arthritisCardiovascular diseaseCarotid plaque |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Iván Ferraz-Amaro Alfonso Corrales Juan Carlos Quevedo-Abeledo Nuria Vegas-Revenga Ricardo Blanco Virginia Portilla Belén Atienza-Mateo Miguel Á. González-Gay |
spellingShingle |
Iván Ferraz-Amaro Alfonso Corrales Juan Carlos Quevedo-Abeledo Nuria Vegas-Revenga Ricardo Blanco Virginia Portilla Belén Atienza-Mateo Miguel Á. González-Gay Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk Arthritis Research & Therapy Rheumatoid arthritis Cardiovascular disease Carotid plaque |
author_facet |
Iván Ferraz-Amaro Alfonso Corrales Juan Carlos Quevedo-Abeledo Nuria Vegas-Revenga Ricardo Blanco Virginia Portilla Belén Atienza-Mateo Miguel Á. González-Gay |
author_sort |
Iván Ferraz-Amaro |
title |
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
title_short |
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
title_full |
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
title_fullStr |
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
title_full_unstemmed |
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
title_sort |
disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
publisher |
BMC |
series |
Arthritis Research & Therapy |
issn |
1478-6362 |
publishDate |
2021-06-01 |
description |
Abstract Background Previous studies have shown that risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the actual cardiovascular (CV) risk of patients with rheumatoid arthritis (RA). In contrast, carotid ultrasound was found to be useful to identify RA patients at high CV. In the present study, we aimed to determine if specific disease features influence the CV risk reclassification of RA patients assessed by SCORE risk charts and carotid ultrasound. Methods 1279 RA patients without previous CV events, diabetes, or chronic kidney disease were studied. Disease characteristics including disease activity scores, CV comorbidity, SCORE calculation, and the presence of carotid plaque by carotid ultrasound were assessed. A multivariable regression analysis was performed to evaluate if the reclassification into very high CV risk category was independently associated with specific features of the disease including disease activity. Additionally, a prediction model for reclassification was constructed in RA patients. Results After carotid ultrasound assessments, 54% of the patients had carotid plaque and consequently fulfilled definition for very high CV risk. Disease activity was statistically significantly associated with reclassification after fully multivariable analysis. A predictive model containing the presence of dyslipidemia and hypertension, an age exceeding 54 years, and a DAS28-ESR score equal or higher than 2.6 yielded the highest discrimination for reclassification. Conclusion Reclassification into very high CV risk after carotid ultrasound assessment occurs in more than the half of patients with RA. This reclassification can be independently explained by the activity of the disease. |
topic |
Rheumatoid arthritis Cardiovascular disease Carotid plaque |
url |
https://doi.org/10.1186/s13075-021-02542-7 |
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