Adherence to cardiovascular prevention strategies in patients with rheumatoid arthritis

Stoep, D. F. Van Breukelen-van der; Zijlmans, J.C.M.; Zeben, Derkjen van; Klop, Boudewijn; Geijn, Gert Jan M. van de; Meulen, N. van der; Hazes, M.; Birnie, Erwin; Cabezas, Manuel Castro

doi:10.3109/03009742.2015.1028997

Cited by 13 publications

(16 citation statements)

References 25 publications

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“…Therefore, they indirectly support the need to improve the management of CV risk, which is still found to be inadequate. 24 Our study has some strengths and limitations. It is the first study on mortality in Italian RA patients, the vital status of whom was known in 93% of patients at the end of follow-up.…”

Section: Discussionmentioning

confidence: 98%

Mortality in Italian patients with rheumatoid arthritis: evidence for a low mortality rate from cancer and infections in patients followed up at a tertiary center

Iacono

Fasano

D'Abrosca

et al. 2017

OARRR

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ObjectivesMortality in patients with rheumatoid arthritis (RA) has never been investigated in Italy. This study is devoted to investigating all the distinct causes of mortality in Italian RA patients.MethodsClinical charts of patients consecutively admitted to an Italian tertiary center, from January 1, 2008 to December 31, 2014, were reviewed. Mortality rates (incidence mortality rate [IMR] and standardized mortality rate [SMR]) and causes of death as assessed at December 31, 2015, were registered. Mortality rates detected in our series were compared to those reported in other European cohorts and in the general Italian population.ResultsSix hundred and eight patients were observed for a median of 3.51 years. Overall IMR was 0.79 deaths/100 person-years. No significant difference between our IMR and that reported in Italian population by the National Institute of Statistics was observed. All-cause and neoplasm IMRs in our series were found to be significantly lower than that reported in the Norfolk Arthritis Registry, while no difference was detected in cardiovascular (CV) mortality. On the other hand, all causes and CV SMRs in our series were found to be higher than that reported in the general Italian population, while cancer and infectious SMRs were found to be lower.ConclusionIn our series, RA patients had an increased all-cause mortality, and in particular an increased death rate due to CV. However, a lower death rate due to cancer and infections was observed. This figure might be due to the careful follow-up of RA patients in tertiary centers, and the results underlines the need to improve the management of CV risk.

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Section: Discussionmentioning

confidence: 98%

Mortality in Italian patients with rheumatoid arthritis: evidence for a low mortality rate from cancer and infections in patients followed up at a tertiary center

Iacono

Fasano

D'Abrosca

et al. 2017

OARRR

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“…We hypothesized that the detected differences might be ascribed either to the careful follow-up that RA patients undergo in tertiary centers, which may decrease mortality by cancer and infections, or to epidemiological differences among RA cohorts from different countries or both these aspects. 25 …”

Section: Discussionmentioning

confidence: 99%

Low mortality rate in Italian rheumatoid arthritis patients from a tertiary center: putative implication of a low anti-carbamylated protein antibodies prevalence

Iacono¹,

Favoino²,

Borgia³

et al. 2018

OARRR

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Background and objectiveAnti-carbamylated protein antibodies (anti-CarP Ab) represent a novel kind of autoantibodies specificity detectable in the sera of patients with rheumatoid arthritis (RA). They have been recently reported to be associated with increased mortality in Spanish patients with RA. The aim of our study was to compare the incidence mortality rates (IMRs) detected in RA patients from a tertiary Italian center with those reported in other European tertiary centers and to evaluate the putative role of anti-CarP Ab in modulating the low IMR detected in our patients.MethodsClinical charts of patients consecutively admitted to our center, from January 1, 2008, to December 31, 2014, were retrospectively reviewed. The mortality rate (expressed as the number of deaths in the cohort divided by the number of years of IMR follow-up) and causes of death were assessed at December 31, 2015. Sera of 61 patients, representative of the whole cohort, collected at the time of admission to our center were investigated for the presence and the level of anti-CarP Ab. Demographic and clinical features, mortality rates and prevalence of anti-CarP Ab in our series were compared with those reported in other European cohorts.ResultsWe observed 608 patients for a median of 3.51 years. All-cause and cause-specific IMRs in our cohort were significantly lower than the Better Anti-rheumatic Farmaco-therapy and the Spanish cohort, while only all-cause and cardiovascular IMRs were significantly lower in our series with respect to the Leiden Early Arthritis Clinic cohort. Anti-CarP Ab prevalence was significantly lower in our series than in any other European cohorts.ConclusionWe confirm that the mortality rate is lower in our Italian RA cohort with respect to other European cohorts. Whether the low prevalence of anti-CarP Ab might be responsible for this result awaits to be furtherly investigated.

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“…9,69 A 2015 cross-sectional study involving 111 patients with rheumatoid arthritis found that, although 53% of these patients were estimated to be at high risk for CVD (defined as a 10-year risk of CVD events of 20% or more), only 3% thought they were at increased cardiovascular risk. 69 This underrecognition of risk may contribute to lower patient adherence to provider recommendations about CVD risk reduction strategies. 69 Lack of awareness among health care providers may also be a factor.…”

Section: Underrecognition Of Cardiovascular Disease and Undertreatmenmentioning

confidence: 99%

“…69 This underrecognition of risk may contribute to lower patient adherence to provider recommendations about CVD risk reduction strategies. 69 Lack of awareness among health care providers may also be a factor. In 2016, a qualitative study involving physicians who provide care to patients with rheumatoid arthritis found that about half of the primary care providers who were interviewed were unaware of the increased CVD risk in these patients.…”

Section: Underrecognition Of Cardiovascular Disease and Undertreatmenmentioning

confidence: 99%

Managing premature atherosclerosis in patients with chronic inflammatory diseases

Legge

Hanly

2018

CMAJ

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hronic inflammatory diseases, including rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis and ankylosing spondylitis, are associated with increased risk of death relative to general population rates. 1-4 This increased risk is largely attributable to atherosclerotic cardiovascular disease (CVD). 2-5 Several studies have shown an increased risk of CVD in patients with chronic inflammatory diseases that is similar to the excess CVD risk conferred by diabetes mellitus 6-a disease for which there are well-established guidelines and practices for CVD prevention. However, CVD risk management strategies in patients with chronic inflammatory diseases remain suboptimal, and studies have shown that CVD is underrecognized and undertreated in this patient population. 7,8 Furthermore, there is evidence that a lack of awareness among health care providers about the association between chronic inflammatory diseases and increased CVD risk may contribute to this disparity. 9 Chronic inflammatory diseases are prevalent as a group of conditions. 10 Optimal CVD prevention in patients with these diseases requires the active participation of multiple health care professionals, including rheumatologists, cardiologists, general internists and primary care practitioners. 11,12 We summarize the evidence that shows increased cardiovascular morbidity and mortality among patients with chronic inflammatory diseases. We outline the underlying factors contributing to this excess CVD burden, highlight the challenges of CVD risk assessment in this population and propose an approach to CVD risk management in patients with chronic inflammatory diseases (our search strategy is in Box 1). What is the burden of cardiovascular disease in those with chronic inflammatory diseases? REVIEW Managing premature atherosclerosis in patients with chronic inflammatory diseases

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Adherence to cardiovascular prevention strategies in patients with rheumatoid arthritis

Abstract: RA patients tend to underestimate their CVD risk. The self-reported adherence of RA patients to CVD risk management was high concerning pharmaceutical interventions and moderate in the case of lifestyle interventions.

Cited by 13 publications

References 25 publications

Mortality in Italian patients with rheumatoid arthritis: evidence for a low mortality rate from cancer and infections in patients followed up at a tertiary center

Mortality in Italian patients with rheumatoid arthritis: evidence for a low mortality rate from cancer and infections in patients followed up at a tertiary center

Low mortality rate in Italian rheumatoid arthritis patients from a tertiary center: putative implication of a low anti-carbamylated protein antibodies prevalence

Managing premature atherosclerosis in patients with chronic inflammatory diseases

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