Cardiovascular risk estimation with 5 different algorithms before and after 5 years of bDMARD treatment in rheumatoid arthritis.

Publisher: Wiley Country of Publication: England NLM ID: 0245331 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2362 (Electronic) Linking ISSN: 00142972 NLM ISO Abbreviation: Eur J Clin Invest Subsets: MEDLINE

Publication: Oxford : Wiley
Original Publication: Berlin, New York, Springer-Verlag, on behalf of the European Society for Clinical Investigation.

Antirheumatic Agents/*therapeutic use ; Arthritis, Rheumatoid/*drug therapy ; Biological Products/*therapeutic use ; Cardiovascular Diseases/*epidemiology; Adult ; Age Factors ; Angina Pectoris/epidemiology ; Arthritis, Rheumatoid/epidemiology ; Atrial Fibrillation/epidemiology ; Blood Pressure ; Body Mass Index ; C-Reactive Protein/metabolism ; Cardiovascular Diseases/mortality ; Cholesterol/blood ; Cholesterol, HDL/blood ; Diabetes Mellitus/epidemiology ; Ethnicity/statistics & numerical data ; Female ; Follow-Up Studies ; Glucocorticoids/therapeutic use ; Heart Disease Risk Factors ; Humans ; Hyperlipidemias/blood ; Hyperlipidemias/drug therapy ; Hyperlipidemias/epidemiology ; Hypertension/drug therapy ; Hypertension/epidemiology ; Ischemic Attack, Transient/epidemiology ; Male ; Medical History Taking ; Middle Aged ; Myocardial Infarction/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Sex Factors ; Smoking/epidemiology ; Stroke/epidemiology

Background: Assessing cardiovascular (CV) risk represents a challenge for clinicians because more variables can impact CV risk. The aim of this study was to evaluate the change of CV risk after 5 years of biological treatment in rheumatoid arthritis (RA) patients and impact of prolonged low disease activity on 5 different CV risk algorithms.
Materials and Methods: We estimated the CV risk, at baseline and at 5-year follow-up (FU), with the Systematic COronary Risk Evaluation(SCORE) charts, the algorithm 'Progetto Cuore', the QRISK3-2018 score, the Reynold Risk Score(RRS) and the Expanded Risk Score in RA(ERS-RA). Clinical disease activity index(CDAI) was used to define RA activity. Wilcoxon signed-rank test was used to compare CV risk scores.
Results: In 110 patients with a 5-year FU on biological disease-modifying anti-rheumatic drug treatment, we observed an increase in the 10-year CV risk estimated by SCORE charts [from mean (SD) 0.9% (1.4) to 1.1% (1.5), P < .001], 'Progetto Cuore' [from mean (SD) 5.5% (7.2) to 6.2% (6.8), P < .001], QRISK3-2018 [from mean (SD) 9.3% (10.1) to 11.9% (10.8), P < .001) and RRS [from mean (SD) 5.6% (6.4) to 6.2% (7.5), P < .05], mainly due to age raise. ERS-RA highlighted a significant decrease of estimated CV risk in patients with persistent CDAI ≤ 10[from mean (SD) 9.6% (11.2) to 7.3% (6.4), P < .05], despite age increase and its impact on the CV risk score.
Conclusions: Algorithms commonly used to estimate 10-year CV risk in RA perform differently. Scores that include specific inflammatory RA-related variables seem to decrease with amelioration of disease activity. Further investigations are warranted to explore the predictive value of their changing over time.
(© 2020 Stichting European Society for Clinical Investigation Journal Foundation.)

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Keywords: algorithms; cardiovascular risk; disease activity; rheumatoid arthritis

0 (Antirheumatic Agents)
0 (Biological Products)
0 (Cholesterol, HDL)
0 (Glucocorticoids)
9007-41-4 (C-Reactive Protein)
97C5T2UQ7J (Cholesterol)

Date Created: 20200713 Date Completed: 20211004 Latest Revision: 20211204

20250114

10.1111/eci.13343

32654116