A G Semb1, E Ikdahl2, J Hisdal3, I C Olsen4, S Rollefstad2. 1. Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: a-semb@diakonsyk.no. 2. Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. 3. Department of Vascular Medicine, Oslo University Hospital Aker, Oslo, Norway. 4. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Abstract
OBJECTIVES: Cardiovascular disease (CVD) risk calculators developed for the general population have been shown to inaccurately predict CVD events in patients with inflammatory joint disease (IJD). European guidelines for CVD prevention recognize the presence of carotid plaques (CP) as a very high CVD risk factor, equivalent of coronary artery disease. Patients with IJD have a high prevalence of CP. We evaluated if CP resulted in reclassification of patients with IJD into a more appropriate CVD risk class and recommended lipid lowering treatment. METHODS: CVD risk evaluation was performed in patients with IJD using SCORE and ACC/AHA risk calculators to predict CVD events. RESULTS: Of the 335 IJD patients evaluated (including rheumatoid arthritis n=201, ankylosing spondylitis n=85 and psoriatic arthritis n=49), 183 and 159 IJD patients had a calculated CVD risk by SCORE and ACC/AHA <5%, indicating no need of lipid lowering treatment (LLT). However, of patients with low to moderate risk calculated by SCORE and ACC/AHA, 67 (36.6%) and 48 (30.2%) had CP and should according to guidelines receive intensive LLT. For patients with high risk, in the LLT considered group, 54.9% and 58.1% were reclassified to correct treatment when adding information on the presence of CP. Our results reveal a considerable reclassification into correct CVD risk category when adding CP in female patients. CONCLUSION: The high frequency of asymptomatic atherosclerosis in patients with IJD has a notable impact on CVD risk stratification. Identification of CP will reclassify patients into recommended CVD preventive treatment group, which may be clinically important.
OBJECTIVES:Cardiovascular disease (CVD) risk calculators developed for the general population have been shown to inaccurately predict CVD events in patients with inflammatory joint disease (IJD). European guidelines for CVD prevention recognize the presence of carotid plaques (CP) as a very high CVD risk factor, equivalent of coronary artery disease. Patients with IJD have a high prevalence of CP. We evaluated if CP resulted in reclassification of patients with IJD into a more appropriate CVD risk class and recommended lipid lowering treatment. METHODS: CVD risk evaluation was performed in patients with IJD using SCORE and ACC/AHA risk calculators to predict CVD events. RESULTS: Of the 335 IJD patients evaluated (including rheumatoid arthritis n=201, ankylosing spondylitis n=85 and psoriatic arthritis n=49), 183 and 159 IJD patients had a calculated CVD risk by SCORE and ACC/AHA <5%, indicating no need of lipid lowering treatment (LLT). However, of patients with low to moderate risk calculated by SCORE and ACC/AHA, 67 (36.6%) and 48 (30.2%) had CP and should according to guidelines receive intensive LLT. For patients with high risk, in the LLT considered group, 54.9% and 58.1% were reclassified to correct treatment when adding information on the presence of CP. Our results reveal a considerable reclassification into correct CVD risk category when adding CP in female patients. CONCLUSION: The high frequency of asymptomatic atherosclerosis in patients with IJD has a notable impact on CVD risk stratification. Identification of CP will reclassify patients into recommended CVD preventive treatment group, which may be clinically important.
Authors: Erin M Scanlon; Rekha Mankad; Cynthia S Crowson; Iftikhar J Kullo; Sharon L Mulvagh; Eric L Matteson; Zoran Kvrgic; John M Davis Journal: Clin Rheumatol Date: 2016-12-17 Impact factor: 2.980
Authors: Cynthia S Crowson; Silvia Rollefstad; Eirik Ikdahl; George D Kitas; Piet L C M van Riel; Sherine E Gabriel; Eric L Matteson; Tore K Kvien; Karen Douglas; Aamer Sandoo; Elke Arts; Solveig Wållberg-Jonsson; Lena Innala; George Karpouzas; Patrick H Dessein; Linda Tsang; Hani El-Gabalawy; Carol Hitchon; Virginia Pascual Ramos; Irazú Contreras Yáñez; Petros P Sfikakis; Evangelia Zampeli; Miguel A Gonzalez-Gay; Alfonso Corrales; Mart van de Laar; Harald E Vonkeman; Inger Meek; Anne Grete Semb Journal: Ann Rheum Dis Date: 2017-09-06 Impact factor: 19.103
Authors: Dionicio A Galarza-Delgado; Jose R Azpiri-Lopez; Iris J Colunga-Pedraza; Natalia Guajardo-Jauregui; Alejandra B Rodriguez-Romero; Salvador Lugo-Perez; Jesus A Cardenas-de la Garza; Rosa I Arvizu-Rivera; Diana E Flores-Alvarado; Octavio Ilizaliturri-Guerra; Gisela Garcia-Arellano; Andrea C Garza-Acosta Journal: Clin Rheumatol Date: 2021-11-26 Impact factor: 2.980
Authors: Tore K Kvien; Alejandro Balsa; Neil Betteridge; Maya H Buch; Patrick Durez; Ennio Giulio Favalli; Guillaume Favier; Cem Gabay; Rinie Geenen; Ioanna Gouni-Berthold; Frank van den Hoogen; Alison Kent; Lars Klareskog; Mikkel Ostergaard; Karel Pavelka; Joaquim Polido Pereira; Anne Grete Semb; Magnus Sköld; Maxime Dougados Journal: RMD Open Date: 2020-07
Authors: Ana M Fernández-Ortiz; Ana M Ortiz; Silvia Pérez; Esther Toledano; Lydia Abásolo; Miguel A González-Gay; Santos Castañeda; Isidoro González-Álvaro Journal: Arthritis Res Ther Date: 2020-09-11 Impact factor: 5.156