Ab1297 cardiovascular Event and Risk Factors in Primary Sjögren’s Syndrome From Latin-American Cohort

Abstract

BackgroundInflammation has been associated with higher cardiovascular risk in rheumatic autoimmune diseases. Primary Sjögren’s syndrome (pSS) is associated with increased cardiovascular morbidity1. However, few and controversy data on the prevalence of cardiovascular events in patients with pSS have been reported2,3 with no data regarding on Latin-American pSS patients.ObjectivesTo assess the cardiovascular event and to evaluate its association with traditional and disease associated risk factors in pSS.MethodsWe included 455 patients with pSS according to AECG 2002 or ACR-EULAR 2016 classification criteria, attending tertiary referral centers from Brazil (n=183), Mexico (n=236) and Argentina (n=36). We retrospectively registered demographics, disease duration, cardiovascular event (CE) (coronary heart disease, cerebrovascular accident, peripheral arterial disease), smoking, and use of prednisone (PDN), immunosupressors and antimalarials. We evaluated traditional risk factors and scored the ESSDAI, ESSPRI and SSDDI at last follow-up.ResultsMost patients were female, miscigenous ethnicity, with median disease duration of 9.5 years. RF was positive in 48.5%, ANA in 85.6%, anti-Ro-SSA in 78.9% and anti-La-SSA in 43.1%. ESSDAI mean was 3.2±4.4, SSDDI 2.54±1.78 and ESSPRI 5.03±2.38. Fifty five percent used glucocorticoid in the past and 20% are curruntly using it, 33.4% are using immunosupressors, 44% antimalarials and 10.3% biological therapy. It was found 26 (5.7%, CI95% 3.73-8.37) CE. The prevalence of hypertension was 35.6%, diabetes 11.2%, dyslipidemia 27.7% and smoking 17.5%. In univariate regression analysis, aging, hypertension, diabetes, dyslipidemia and smoking were associated with CE. Beyond traditional risk factors, prednisone > 20mg/day, ESSDAI constitutional domain and ESSPRI fatigue were associated with CE. In multivariate analysis, aging OR= 1.037 (1.001-1.075, p= 0.043), hypertension OR=2.509 (1.028-6.128, p=0.043) and diabetes OR= 2.736 (1.059-7.070, 0.038) were independent risk for CE.ConclusionTraditional risk factors are independent risk for CE in pSS. Disease-associated factors, such as glucocorticoid, fatigue and disease activity seem to be associated and should be explored in larger samples.References[1] Beltai A, et al. Cardiovascular morbidity and mortality in primary Sjögren syndrome: a systematic review and meta-analysis. Arthritis Care Res, 2018 (Epub ahead of print);[2] Valim V, et al. Atherosclerosis in Sjögren’s syndrome: evidence, possible mechanisms and knowledge gaps. Gerdts Clin Exp Rheumatol.34(1):133-42, 2016.[3] Berardicurti O, et al. Cardiovascular Disease in Primary Sjögren’s Syndrome. Rev Recent Clin Trial 13(3):164-169, 2018.Disclosure of InterestsNone declared

Prevalence of Chronic Diseases among International Travelers Seeking Pretravel Medical Advice in 2018 at Malaga, Spain

“…We asked travelers about their chronic conditions using the WHO chronic disease classification, 5 but other studies have used alternatives that make it difficult to directly compare the results. Factors or conditions known to interact with the most common pretravel prescriptions for malaria, yellow fever, or diarrhea were included in the study by Van de Winkel et al, 4 Valim et al, 19 Bica et al 20 However, Aubry et al, 3 in their prospective study on travelers visiting pretravel medical consultations, collected more detailed information about chronic medical conditions. They excluded pilgrims to Mecca in the Haj and people like the crew of planes and ships.…”