Arterial stiffness is said to be a novel predictor of cardiovascular events. This study investigated the correlation between arterial stiffness parameters and the estimated cardiovascular disease risk (RISK) in a Polish cohort of patients divided by age, sex, and body-mass index (BMI). The cross-sectional study enrolled 295 patients who met the inclusion criteria. Subjects were divided into three age groups, four weight groups, and by gender. The stiffness of the vessels was assessed by the measurement of the stiffness index (SI) and reflection index (RI). An individual 10-year RISK was calculated for each patient using the Heart Risk Calculator algorithm by the American Heart Association. A correlation between the SI and estimated RISK was observed (rS 0.42, p < 0.05). The strongest relationship was presented for women, the age group 40–54, and individuals with normal weight. The correlation between RI and calculated RISK was observed (rS 0.19, p < 0.05), the highest correlation was noticed for people aged 40–54 and obese. In conclusion, both SI and RI are correlated with estimated cardiovascular risk, however SI seems to be more useful than RI to predict the individual risk of future cardiovascular events. Both of these can be measured using non-invasive techniques, which demonstrates their potential utility in clinical practice.
Objectives: Rheumatoid arthritis (RA) affects patients' capacity to work. The Rheumatoid Arthritis Work Instability Scale (RA-WIS) is a reliable method to measure work instability (WI) (1-3). We lack data on the relationship between RA and work instability among Polish patients. Our study aimed to assess WI and associated factors among patients with RA. Material and methods: The authors conducted a multi-centre cross-sectional observational study. 315 patients from three rheumatology centres were enrolled and filled in questionnaires, including demographic and self-reported clinical data, RA-WIS, and the Health Assessment Questionnaire (HAQ). Swollen and tender joint counts (SJC, TJC) were assessed by the attending physician, and current erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. We excluded 41 patients due to an incorrectly filled in form and analysed questionnaires of 274 patients. DAS28 (Disease Activity Score in 28 joints) and DAS28-CRP were calculated. We performed statistical analysis with Statistica v. 13.3 using the Mann-Whitney U test, χ 2 test, and Spearman's correlation. Results: 140 (51%) patients were currently employed and their characteristics were analysed. In univariable analysis we identified the following risk factors for high risk WI: moderate-to-high disease activity (DAS28 ≥ 3.2-OR 2.29, 95% CI 1.06-4.96, p = 0.033; DAS28-CRP ≥ 3.2-OR 2.34, 95% CI 1.04-5.27, p = 0.038), ESR ≥ 30 mm/h in women and ≥ 20 mm/h in men (OR 2.65, 95% CI 1.20-5.89, p = 0.010), CRP ≥ 1 mg/dl (OR 4.02, 95% CI 1.78-9.10, p < 0.001), HAQ-DI > 1.0 (OR 2.23, 95% CI 1.04-4.81, p = 0.037) and at least moderate pain on the visual analogue scale (VAS p ≥ 4.5 cm-OR 5.31, 95% CI 2.36-11.96, p < 0.001). Correlations were moderate between RA-WIS and VASp (RS = 0.59, p < 0.001) and HAQ-DI (RS = 0.52, p < 0.001) but weak with disease activity indices (DAS28 [RS = 0.31, p < 0.001]; DAS28-CRP [RS = 0.28, p < 0.001]). Conclusions: Pain and disability are the main factors strongly associated with work instability among patients with RA.
Background:Rheumatoid arthritis (RA) affects patients’ capacity to work. Rheumatoid Arthritis Work Instability Scale (RA-WIS) is a reliable method to measure work instability (WI) (1–3). We lack data on relationship between RA and work instability among Polish patients.Objectives:The aim of our study was to assess WI and associated factors among patients with RA.Methods:315 patients from three rheumatology centres were enrolled and filled questionnaires including demographic and self-reported clinical data, RA-WIS, and The Health Assessment Questionnaire (HAQ). Swollen and tender joints count (SJC, TJC) were assessed by attending physician and current erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. We excluded 41 patients due to incorrectly filled form and analysed questionnaires of 274 patients. DAS28 (Disease Activity Score in 28 joints) and DAS28-CRP were calculated. We performed statistical analysis with Statistica v. 13.3 using Mann-Whitney U test, chi-square test and Spearman’s correlationResults:140 (51 %) patients were employed and their characteristics are presented on Table 1. In univariable analysis we identified following risk factors for high risk WI: moderate-to-high disease activity (DAS28≥3.2 – OR 2.29, 95%CI 1.06-4.96, p=0.033; DAS28-CRP≥3.2 – OR 2.34, 95%CI 1.04-5.27, p=0.038), ESR ≥30 mm/h in women and ≥20 mm/h in men (OR 2.65, 95%CI 1.20-5.89, p=0.010), CRP≥1mg/dL (OR 4.02, 95%CI 1.78-9.10 p<0.001), HAQ-DI>1.0 (OR 2.23, 95%CI 1.04-4.81, p=0.037) and at least moderate pain on visual analogue scale (VASp ≥4.5 cm - OR 5.31, 95%CI 2.36-11.96, p<0.001). Correlations were moderate between RA-WIS and VASp (RS=0.59, p<0.001) and HAQ-DI (RS=0.52, p<0.001) whereas weak with disease activity indices (DAS28 - RS=0.31, p<0.001; DAS28-CRP - RS=0.28, p<0.001).Table 1.Demographic and clinical characteristics of employed patients according to work instability risk, N(%) or mean(±SD).CharacteristicRA-WIS scorelow-to-moderate (0-17)high (>17)Patients94 (67.1%)46 (32.9%)Sex, female73 (77.7%)38 (82.6%)Age (years)47.9 (±11.8)50.4 (±9.3)Disease duration (years)13.0 (±8.4)14.0 (±8.7)RF, positive68 (72.3%)34 (73.9%)ACPA, positive59 (62.8%)29 (63.0%)ESR (mm/h)18.3 (±16.0)28.2 (± 21.9)*CRP (mg/dL)0.6 (± 1.0)1.1 (± 1.0)*TJC4.5 (±4.0)7.6(±6.3)*SJC2.7 (±3.0)5.2(±5.5)*HAQ-DI0.7 (±0.5)1.1 (±0.5)*pain - VAS 10 cm3.9 (±1.9)6.5 (± 2.2)*DAS283.5 (±1.2)4.2 (±1.4)*DAS28-CRP3.9 (±1.0)4.3 (±1.2)*WI – work instability, RA-WIS – Rheumatoid Arthritis Work Instability Scale, RF – rheumatoid factor in IgM class, ACPA – anti-citrullinated protein antibodies, ESR – erythrocyte sedimentation rate, CRP – C-reactive protein, TJC – tender joints count, SJC – swollen joints count, HAQ-DI – Heath Assessment Questionnaire Disability Index, VAS – visual analogue scale, DAS28 – Disease Activity Score in 28 joints*p<0.05, Mann-Whitney U testConclusion:Pain and disability are main factors associated with work instability among patients with RA.References:[1]Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, et al. Development of a work instability scale for rheumatoid arthritis. Arthritis Rheum. 2003;49(3):349–54.[2]Gilworth G, Emery P, Gossec L, Vlieland TPMV, Breedveld FC, Hueber AJ, et al. Adaptation and cross-cultural validation of the rheumatoid arthritis work instability scale (RA–WIS). Ann Rheum Dis. 2009;68(11):1686–90.[3]Revicki D, Ganguli A, Kimel M, Roy S, Chen N, Safikhani S, et al. Reliability and Validity of the Work Instability Scale for Rheumatoid Arthritis. Value Health J Int Soc Pharmacoeconomics Outcomes Res. 2015;18(8):1008–15.Disclosure of Interests:None declared
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