Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk
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 patie...
| Authors: | ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Publication date: | 2021 |
| Country: | España |
| Institution: | Universidad de Cantabria (UC) |
| Repository: | UCrea Repositorio Abierto de la Universidad de Cantabria |
| Language: | English |
| OAI Identifier: | oai:repositorio.unican.es:10902/24436 |
| Online Access: | http://hdl.handle.net/10902/24436 |
| Access Level: | Open access |
| Keyword: | Rheumatoid arthritis Cardiovascular disease Carotid plaque |
| _version_ | 1878729685059239936 |
|---|---|
| author | Ferraz-Amaro, Iván |
| author2 | Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco Alonso, Ricardo|||0000-0003-2344-2285 Portilla, Virginia Atienza Mateo, Belén González-Gay Mantecón, Miguel Ángel |
| author2_role | author author author author author author author |
| author_browse | Atienza Mateo, Belén Blanco Alonso, Ricardo|||0000-0003-2344-2285 Corrales, Alfonso Ferraz-Amaro, Iván González-Gay Mantecón, Miguel Ángel Portilla, Virginia Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria |
| author_facet | Ferraz-Amaro, Iván Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco Alonso, Ricardo|||0000-0003-2344-2285 Portilla, Virginia Atienza Mateo, Belén González-Gay Mantecón, Miguel Ángel |
| author_role | author |
| collection | UCrea Repositorio Abierto de la Universidad de Cantabria |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_0cec4e3ee09dcf431cdf32cae981d6ae |
| institution | Universidad de Cantabria (UC) |
| instname_str | Universidad de Cantabria (UC) |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositorio.unican.es:10902/24436 |
| publishDate | 2021 |
| publishDateSort | 2021 |
| publisher | BioMed Central |
| publisherStr | BioMed Central |
| reponame_str | UCrea Repositorio Abierto de la Universidad de Cantabria |
| spelling | Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk Ferraz-Amaro, Iván Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco Alonso, Ricardo|||0000-0003-2344-2285 Portilla, Virginia Atienza Mateo, Belén González-Gay Mantecón, Miguel Ángel Rheumatoid arthritis Cardiovascular disease Carotid plaque 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. Funding: This work was supported by a grant to I.F-A. from the Spanish Ministry of Health, Subdirección General de Evaluación y Fomento de la Investigación, Plan Estatal de Investigación Científica y Técnica y de Innovación 2013–2016, and by Fondo Europeo de Desarrollo Regional — FEDER (Fondo de Investigaciones Sanitarias, FIS PI14/00394, PI17/00083). Prof. González-Gay’s research is supported by the Instituto de Salud Carlos III (ISCIII) (Fondo de Investigación Sanitaria grants PI06/0024, PI09/00748, PI12/00060, PI15/00525, PI18/00043) and the ISCIII RETICS programs (RD12/0009 and RD16/0012). BioMed Central http://hdl.handle.net/10902/24436 |
| spellingShingle | Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk Ferraz-Amaro, Iván Rheumatoid arthritis Cardiovascular disease Carotid plaque |
| title | 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_short | 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 |
| topic | Rheumatoid arthritis Cardiovascular disease Carotid plaque |
| topic_facet | Rheumatoid arthritis Cardiovascular disease Carotid plaque |
| url | http://hdl.handle.net/10902/24436 |