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Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index

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Abstract

To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1–3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1–3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed.

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Authors and Affiliations

  1. Rheumatology Division, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain

    Carmen Gómez-Vaquero, Montserrat Robustillo, Javier Narváez, Jesús Rodríguez-Moreno & Joan Miquel Nolla

  2. Cardiology Division, Hospital Xeral-Calde, Lugo, Spain

    Carlos González-Juanatey

  3. Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IFIMAV and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain

    Javier Llorca

  4. Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IFIMAV, Avenida de Valdecilla s/n, 39008, Santander, Spain

    Miguel Angel González-Gay

Authors
  1. Carmen Gómez-Vaquero
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  2. Montserrat Robustillo
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  3. Javier Narváez
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  4. Jesús Rodríguez-Moreno
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  5. Carlos González-Juanatey
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  6. Javier Llorca
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  7. Joan Miquel Nolla
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  8. Miguel Angel González-Gay
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Correspondence to Miguel Angel González-Gay.

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Gómez-Vaquero, C., Robustillo, M., Narváez, J. et al. Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index. Clin Rheumatol 31, 35–39 (2012). https://doi.org/10.1007/s10067-011-1774-6

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  • DOI: https://doi.org/10.1007/s10067-011-1774-6

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