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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176689/ https://www.ncbi.nlm.nih.gov/pubmed/34088356 http://dx.doi.org/10.1186/s13075-021-02542-7 |
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author | Ferraz-Amaro, Iván Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco, Ricardo Portilla, Virginia Atienza-Mateo, Belén González-Gay, Miguel Á. |
author_facet | Ferraz-Amaro, Iván Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco, Ricardo Portilla, Virginia Atienza-Mateo, Belén González-Gay, Miguel Á. |
author_sort | Ferraz-Amaro, Iván |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-8176689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81766892021-06-04 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, Ricardo Portilla, Virginia Atienza-Mateo, Belén González-Gay, Miguel Á. Arthritis Res Ther Research Article 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. BioMed Central 2021-06-04 2021 /pmc/articles/PMC8176689/ /pubmed/34088356 http://dx.doi.org/10.1186/s13075-021-02542-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ferraz-Amaro, Iván Corrales, Alfonso Quevedo-Abeledo, Juan Carlos Vegas-Revenga, Nuria Blanco, Ricardo Portilla, Virginia Atienza-Mateo, Belén González-Gay, Miguel Á. Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk |
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 | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176689/ https://www.ncbi.nlm.nih.gov/pubmed/34088356 http://dx.doi.org/10.1186/s13075-021-02542-7 |
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