Assessing the cardiovascular risk burden

Published Date: 19th July 2016

Publication Authors: Patel V, , Abernethy R, Dawson J, Clewes A, Novak J, Cox A, Williams J, O'Rourke T

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Background 

Rheumatoid arthritis (RA) is associated with the increased risk of cardiovascular (CV) mortality and morbidity. There are recommendations by European League against Rheumatism (EULAR) and National Institute for Health and Clinical Excellence (NICE) to include assessment of cardiovascular, osteoporosis, infection and depression risks annually. One of the ways CV risk is calculated is by assessing the 10-year risk of having CV event.

Objectives

The objective was to determine the relationship of the traditional CV risk factors and compare with RA patients on disease modifying agents (DMARDs) and biologics therapy.

Methods 

Data was collected retrospectively using a standardised data collection tool for all the 231 patients who attended the annual review clinics in the last 4 year from Aug 2006 to Aug 2011. Data was analysed by Fisher Exact test for discrete values and unpaired t-test for non-discrete values.

Results 

The demographic characteristics of patients are shown in the table 1. The prevalence of various risk factors and CV risk in biological and DMARD patients are mentioned in table 2.

Conclusions 

A multi-disciplinary annual review clinic allows assessing and predicting the CV risks. Our audit shows CV risk is prevalent in RA patients treated with DMARDS, which warrants regular screening. The CV risk was 23% in overall patients and it was 7% and 30% in biologics and DMARD patient’s respectively. This is the first study to show reduced CV risk in patients treated with biological therapy, most probably through the known beneficial effects on metabolism. We need further studies to confirm that the patients on biologics have lesser CV risk and to see if this translates into reduced cardiovascular disease in the long term. 

 

Patel, V; Karjigi, U; Abernethy, R; Dawson, J; Clewes, A; Novak, J; Cox, A; Williams, J; O'Rourke, T. (2013). Assessing the cardiovascular risk burden in patients with rheumatoid arthritis: Role of annual review clinic . Annals of the Rheumatic Diseases. 71 (Suppl 3), 180

 

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