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...

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Autores: Ferraz-Amaro, Iván, Corrales, Alfonso, Quevedo-Abeledo, Juan Carlos, Vegas-Revenga, Nuria, Blanco Alonso, Ricardo|||0000-0003-2344-2285, Portilla, Virginia, Atienza Mateo, Belén, González-Gay Mantecón, Miguel Ángel
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/24436
Acceso en línea:http://hdl.handle.net/10902/24436
Access Level:acceso abierto
Palabra clave:Rheumatoid arthritis
Cardiovascular disease
Carotid plaque
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spelling Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular riskFerraz-Amaro, IvánCorrales, AlfonsoQuevedo-Abeledo, Juan CarlosVegas-Revenga, NuriaBlanco Alonso, Ricardo|||0000-0003-2344-2285Portilla, VirginiaAtienza Mateo, BelénGonzález-Gay Mantecón, Miguel ÁngelRheumatoid arthritisCardiovascular diseaseCarotid plaqueBackground: 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.Funding: This work was supported by a grant to I.F-A. from the Spanish Ministry of Health, Subdirección General de Evaluación y Fomento de la Investigación, Plan Estatal de Investigación Científica y Técnica y de Innovación 2013–2016, and by Fondo Europeo de Desarrollo Regional — FEDER (Fondo de Investigaciones Sanitarias, FIS PI14/00394, PI17/00083). Prof. González-Gay’s research is supported by the Instituto de Salud Carlos III (ISCIII) (Fondo de Investigación Sanitaria grants PI06/0024, PI09/00748, PI12/00060, PI15/00525, PI18/00043) and the ISCIII RETICS programs (RD12/0009 and RD16/0012).BioMed CentralUniversidad de Cantabria20212021-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttp://hdl.handle.net/10902/24436Arthritis Res Ther . 2021 Jun 4;23(1):162reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/244362026-06-02T12:39:31Z
dc.title.none.fl_str_mv 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
spellingShingle Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk
Ferraz-Amaro, Iván
Rheumatoid arthritis
Cardiovascular disease
Carotid plaque
title_short 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_sort Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk
dc.creator.none.fl_str_mv Ferraz-Amaro, Iván
Corrales, Alfonso
Quevedo-Abeledo, Juan Carlos
Vegas-Revenga, Nuria
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Portilla, Virginia
Atienza Mateo, Belén
González-Gay Mantecón, Miguel Ángel
author Ferraz-Amaro, Iván
author_facet Ferraz-Amaro, Iván
Corrales, Alfonso
Quevedo-Abeledo, Juan Carlos
Vegas-Revenga, Nuria
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Portilla, Virginia
Atienza Mateo, Belén
González-Gay Mantecón, Miguel Ángel
author_role author
author2 Corrales, Alfonso
Quevedo-Abeledo, Juan Carlos
Vegas-Revenga, Nuria
Blanco Alonso, Ricardo|||0000-0003-2344-2285
Portilla, Virginia
Atienza Mateo, Belén
González-Gay Mantecón, Miguel Ángel
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Rheumatoid arthritis
Cardiovascular disease
Carotid plaque
topic Rheumatoid arthritis
Cardiovascular disease
Carotid plaque
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.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10902/24436
url http://hdl.handle.net/10902/24436
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Arthritis Res Ther . 2021 Jun 4;23(1):162
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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