Anne Tournadre1, Zuzana Tatar2, Bruno Pereira3, Maxime Chevreau4, Laure Gossec5, Philippe Gaudin6, Martin Soubrier7, Maxime Dougados8. 1. CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: atournadre@chu-clermontferrand.fr. 2. CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: zkubandova@gmail.com. 3. CHU Clermont-Ferrand, Biostatistics Unit, France. Electronic address: bpereira@chu-clermontferrand.fr. 4. CHU Grenoble, Sud Hospital, Rheumatology Department, Grenoble, France. Electronic address: MChevreau@chu-grenoble.fr. 5. Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, F-75013 Paris, France. Electronic address: laure.gossec@psl.aphp.fr. 6. CHU Grenoble, Sud Hospital, Rheumatology Department, Grenoble, France. Electronic address: PGaudin@chu-grenoble.fr. 7. CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: msoubrier@chu-clermontferrand.fr. 8. Rhumatologie B, Cochin Hospital, Paris, France; René Descartes University, INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Rhumatologie B, Cochin Hospital, 27 rue du Fbg Saint-Jacques, Paris, France. Electronic address: maxime.dougados@cch.aphp.fr.
Abstract
BACKGROUND: Patients with rheumatoid arthritis (RA) have greater rates of cardiovascular mortality and RA is an independent cardiovascular risk factor. For the management of cholesterol, the American College of Cardiology/American Heart Association (ACC/AHA) developed new guidelines for the general population. None of the European or American guidelines are specific to RA. The European League Against Rheumatism (EULAR) recommends applying a coefficient to cardiovascular risk equations based on the characteristics of RA. Our objective was to compare the three different sets of guidelines for the eligibility of statin therapy in RA-specific population with very high risk of cardiovascular disease. METHODS AND RESULTS: We calculated the proportion of patients eligible for statins according to the guidelines of the European Society of Cardiology (ESC), the Adult Treatment Panel III (ATP-III) and the ACC/AHA in a French cohort of statin-naïve RA patients at least 40 years age. Of the 547 women and 130 men analyzed, statins would be recommended for 9.1% of the women and 26.4% of the men, 15.6% of the women and 53.1% of the men, 38.8% of the women and 78.5% of the men, according to the ESC, ATP-III and ACC/AHA guidelines respectively. CONCLUSIONS: In RA patients, as has been observed in the general population, discordance in risk assessment and cholesterol treatment was observed between the three sets of guidelines. The use of the new ACC/AHA guidelines would expand the eligibility for statins and may be applied to RA population a condition at very high risk of cardiovascular disease.
BACKGROUND:Patients with rheumatoid arthritis (RA) have greater rates of cardiovascular mortality and RA is an independent cardiovascular risk factor. For the management of cholesterol, the American College of Cardiology/American Heart Association (ACC/AHA) developed new guidelines for the general population. None of the European or American guidelines are specific to RA. The European League Against Rheumatism (EULAR) recommends applying a coefficient to cardiovascular risk equations based on the characteristics of RA. Our objective was to compare the three different sets of guidelines for the eligibility of statin therapy in RA-specific population with very high risk of cardiovascular disease. METHODS AND RESULTS: We calculated the proportion of patients eligible for statins according to the guidelines of the European Society of Cardiology (ESC), the Adult Treatment Panel III (ATP-III) and the ACC/AHA in a French cohort of statin-naïve RApatients at least 40 years age. Of the 547 women and 130 men analyzed, statins would be recommended for 9.1% of the women and 26.4% of the men, 15.6% of the women and 53.1% of the men, 38.8% of the women and 78.5% of the men, according to the ESC, ATP-III and ACC/AHA guidelines respectively. CONCLUSIONS: In RApatients, as has been observed in the general population, discordance in risk assessment and cholesterol treatment was observed between the three sets of guidelines. The use of the new ACC/AHA guidelines would expand the eligibility for statins and may be applied to RA population a condition at very high risk of cardiovascular disease.