Subclinical atherosclerosis and history of cardiovascular events in Italian patients with rheumatoid arthritis

Ruscitti, Piero; Margiotta, Domenico Paolo Emanuele; Macaluso, Federica; Iacono, Daniela; Donofrio, Francesca; Emmi, Giacomo; Atzeni, Fabiola; Prete, Marcella; Perosa, Federico; Sarzi‐Puttini, Piercarlo; Emmi, Lorenzo; Cantatore, Francesco Paolo; Triolo, Giovanni; Afeltra, Antonella; Giacomelli, Roberto; Valentini, Gabriele

doi:10.1097/md.0000000000008180

Cited by 22 publications

(23 citation statements)

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“…They found also a high prevalence when compared with our study, 35.5% in black patients in South Africa and 32% in Kinshasa (Democratic Republic of Congo) [9] [18]. However, in Italia and India, the prevalence of subclinical atherosclerosis was slightly lower to this present study, respectively 16% and 15.2% [16] [17]. This could suggest differences due to environmental and genetic factors.…”

Section: Ambrosino Et Al Reported a Meta-analysis Of 59 Observationcontrasting

confidence: 71%

“…Mulumba et al, reported also an association with older age and HT [18]. Ruscitti et al, showed also a correlation between atherosclerosis and HT [16]. Despite the well-known implication of other CV risk factors such as diabetes-mellitus, smoking, dyslipidemia, or metabolic syndrome, our study failed to demonstrate the expected association among these factors and subclinical atherosclerosis.…”

Section: Ambrosino Et Al Reported a Meta-analysis Of 59 Observationcontrasting

confidence: 70%

“…RA is the first chronic rheumatism in the general population [2] [23] [24]. This World Journal of Cardiovascular Diseases chronic inflammatory disease is associated with an increased risk of mortality, as compared with general population, mainly due to cardiovascular events [1] [3]- [16]. The mechanisms leading to accelerated atherosclerosis and increased rate of CV events are complex including traditional CV factors, systemic chronic inflammation; genetic compound; RA therapies such as corticosteroids [16] [25].…”

Section: Discussionmentioning

confidence: 99%

“…RA is associated with increasing of cardiovascular (CV) morbidity and mortality due to accelerated atherosclerosis. Thus, there is evidence of close relationship between RA and CV events such as stroke, congestive heart-failure and myocardial infarction [1] [3]- [16].…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Risk and Subclinical Atherosclerosis in Senegalese Patients with Rheumatoid Arthritis: A Cross-Sectional Study in a Single Centre

Kane¹,

Ndao²,

Samba³

et al. 2020

WJCD

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Introduction: Rheumatoid arthritis (RA) is associated with increasing of cardiovascular (CV) morbidity and mortality due to accelerated atherosclerosis. Several studies showed also the increasing of the prevalence of subclinical atherosclerosis, but there are little data from sub-Saharan Africa. The aim of our study was to assess the prevalence of cardiovascular risk factors, subclinical carotid atherosclerosis and the ability of the Systematic Coronary Risk Estimation (SCORE) modified by European League Against Rheumatism (EULAR) to predict the high CV risk in our patients. Patients and Method: We conducted a cross sectional study in Senegalese patients with RA. The RA was retained according to 2010 American College of Rheumatology (ACR)-European League Against Rheumatism (EULAR) criteria. Patients with RA were assessed in a clinical research consultation. Results: We included 50 RA patients. The mean age was 44 years (+/− 12.37) and the sex-ratio was 0.06. The frequency distribution of traditional cardiovascular risk factors was: hypertension (HT) (30%), diabetes-mellitus (6%), smoking (2%), no-exercise (22%), obesity (16%), metabolic syndrome (8%). Fifty-eight percent of patients were classified at low cardiovascular risk according to mSCORE. 51.7% of patients classified as moderate-risk according to mSCORE, were reclassified as high cardiovascular risk according to carotid ultrasound evaluation (gold-standard). The sensitivity of the mSCORE in the prediction of high CV risk was low at 20%. In the present study, the prevalence of carotid subclinical atherosclerosis was 20%. Age (>45 years

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Section: Ambrosino Et Al Reported a Meta-analysis Of 59 Observationcontrasting

confidence: 71%

Section: Ambrosino Et Al Reported a Meta-analysis Of 59 Observationcontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Risk and Subclinical Atherosclerosis in Senegalese Patients with Rheumatoid Arthritis: A Cross-Sectional Study in a Single Centre

Kane¹,

Ndao²,

Samba³

et al. 2020

WJCD

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“…Methods: During 2015, consecutive patients, admitted to Italian Rheumatology Units, were assessed in GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale) cohort [2]. After that, patients were followed-up in a 3year, prospective, observational study, assessing the occurrence of subclinical (carotid and/or peripheral arteries atherosclerotic lesions detected by ultrasound imaging) and clinical atherosclerosis (myocardial infarction and/or congestive heart failure and/or cerebrovascular accidents) and possible predictive factors.…”

Section: Scientific Abstractsmentioning

confidence: 99%

Op0090 the Occurrence of Subclinical and Clinical Atherosclerosis in Rheumatoid Arthritis, Results From the 3-Year, Multicenter, Prospective, Observational, Girrcs Study

et al. 2019

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BackgroundThe systemic inflammatory process and the “traditional” cardiovascular (CV) risk factors could synergize the enhancement of CV burden in rheumatoid arthritis (RA) [1].ObjectivesTo assess the occurrence and the predictive factors of subclinical and clinical atherosclerosis in patients with RA.MethodsDuring 2015, consecutive patients, admitted to Italian Rheumatology Units, were assessed in GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale) cohort [2]. After that, patients were followed-up in a 3-year, prospective, observational study, assessing the occurrence of subclinical (carotid and/or peripheral arteries atherosclerotic lesions detected by ultrasound imaging) and clinical atherosclerosis (myocardial infarction and/or congestive heart failure and/or cerebrovascular accidents) and possible predictive factors. McNemar test was employed to assess the changes in subclinical and clinical atherosclerosis and regression analyses exploited the ORs for the occurrence of those comorbidities.ResultsAfter 3 years of prospective follow-up, 797 patients (82.7% female, median age of 60 years, range 21-89) were assessed. We also observed a median RA duration of 8.35 years (range 0.1-35), 70.9% of patients showed rheumatoid factor and 55.7% ACPA. Among “traditional” CV risk factors, we observed that BMI was 27.21 ± 4.05, 33% of patients reported smoking habit, 49.3% were affected by high blood pressure (HBP) and 12.3% by type 2 diabetes (T2D). Corticosteroids were administered in 75.5% of patients (low dosage 66.8%), methotrexate in 86.8%, hydroxychloroquine in 28.1% and biologic DMARDs in 60.7%. The remission was reached and maintained in 42.6% of patients, during the follow-up. We recorded an increased rate of subclinical atherosclerosis (70 vs 130 patients p<0.0001) and clinical atherosclerosis (30 vs 46 patients, p<0.001), at the end of follow-up. The multivariate regression analysis showed that T2D (OR: 4.50, 95%CI:1.74-11.62, p=0.002), HBP (OR: 2.03, 95%CI:1.04-4.14, p=0.042), ACPA (OR: 2.36, 95%CI:1.19-4.69, p=0.002) and mean values of CRP during the follow-up (OR: 1.07, 95%CI: 1.03-1.14, p=0.040) were associated with subclinical atherosclerosis. Differently, the maintenance of remission was associated with a reduced risk of subclinical atherosclerosis (OR: 0.25, 95%CI: 0.11-0.56, p=0.001). The multivariate regression analysis showed that T2D was associated with clinical atherosclerosis (OR:6.21, 95%CI:2.19-17.71, p=0.001). Conversely, the maintenance of remission was associated with a reduced risk of clinical atherosclerosis (OR:0.20, 95%CI: 0.09-0.95, p=0.041).ConclusionThe maintenance of remission was strongly associated with a reduced risk of clinical and subclinical atherosclerosis in 3-year prospective follow-up. Among “traditional” CV risk factors, T2D was significantly associated with both clinical and subclinical atherosclerosis.References[1] Nurmohamed MT, et al. Nat Rev Rheumatol. 201511:693-704[2] Ruscitti P, et al. Medicine (Baltimore). 2017;96:e8180.Disclosure of InterestsP...

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Cardiovascular and Metabolic Comorbidities in Rheumatoid Arthritis

et al. 2018

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Subclinical atherosclerosis and history of cardiovascular events in Italian patients with rheumatoid arthritis

Abstract: Supplemental Digital Content is available in the text

Cited by 22 publications

References 67 publications

Cardiovascular Risk and Subclinical Atherosclerosis in Senegalese Patients with Rheumatoid Arthritis: A Cross-Sectional Study in a Single Centre

Cardiovascular Risk and Subclinical Atherosclerosis in Senegalese Patients with Rheumatoid Arthritis: A Cross-Sectional Study in a Single Centre

Op0090 the Occurrence of Subclinical and Clinical Atherosclerosis in Rheumatoid Arthritis, Results From the 3-Year, Multicenter, Prospective, Observational, Girrcs Study

Cardiovascular and Metabolic Comorbidities in Rheumatoid Arthritis

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