SAT0576 Score Understimates the Real Cardiovascular Risk in Psoriatic Arthritis
Authors: M. Martínez-Vidal, F. Sivera, C. Fernández-Carballido, R. Martín-Doménech, A. San Martín-Άlvarez
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> SCORE understimates real Cardiovascualr Risk (CVR) in Rheumatoid ARtrhtis (1) and CVR in Psoriatic Arthritis (PsA) may be underestimated (2) too. The carotid intima-media thickness (CIMT) and the presence of atheroma plaques by Ultrasound (US) are significantly associated with risk for stroke or coronary heart disease (3) and translate a very high CVR <h3>Objectives</h3> To assess the CVR in PsA patients according to the SCORE chart, and the presence of subclinical vascular disease by US <h3>Methods</h3> Ongoing transversal descriptive study of PsA patients followed in our Rheumatology Division approved by the Ethic Committee of our Hospital. Clinical characteristics were recorded: age, gender, duration and type of disease, therapy; presence of classical CVR factors including body mass index (BMI), hypertension, dyslipidaemia, tobacco, and diabetes; personal and familiar cardiovascular events; lipid profile:total cholesterol (TC), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) within the previous three months. CVR was calculated with SCORE calibrated for Spain (4). The patients underwent bilateral US carotid study with a GE LOGIQ S7 US Equipment. Billaterally the CIMT and the presence of atheroma plaques were assessed according to the Mannheim consensus (5). Patientes were reclassified upon US results. <h3>Results</h3> 40 patients included. Age was 55.8 years (SD 10.6) and 50% were female. Clinical characteristics are described in Table 1. The percentage of patients in the four levels of CVR (low, intermediate, high, and very high) was 0%, 67.5%, 25% and 7.5% respectively. 14 patients had plaques (35%), 13 (32.5%) were at the left side and 5 (12%) at the right side. In univariate analysis, plaques were associated with diabetes (P=0,005), hypertension (P=0,027) and age (P=0,039), but not with gender, dyslipidaemia, tobacco, neither length nor spectrum of the disease. 13 patients (32.5%) were reclassified and upgraded to very high risk. The final number of patients was 17 (42%), 8 (20%) and 15 (37.5%) for intermediate, high and very high risk respectively <h3>Conclusions</h3> The preliminary results of our patients with PsA show a substantial proportion of patients with a high or very high risk <i>a priori</i> of a fatal CV event. SCORE classification appears to underestimate the real CV risk done as 38% of patients have an estimated very high risk after the US study. These results, even in this short series, have relevant significance as most of the patients will require a specific therapeutic approach. <h3>References</h3> Peters MJ et al. EULAR evidenced-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis2010;69:325–31. Rosales JL et al. Cardiovascular risk assessment according to a national calibrated score risk index in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. J B Spine. 2014 Mar;:164-8. Lin YC et al. Relationship between metabolic syndrome and carotid intima-media thickness: cross-sectional comparison between psoriasis and psoriatic arthritis. Arthritis Care Res (Hoboken). 2014 jan;66(1):97-103. Sans S et al. Calibraciόn de la tabla SCORE del riesgo cardiovascular para España. Rev Esp Cardiol 2007;60:476–85. T ouboul PJ et al. Mannheim carotid intima-media thickness and plaque consensus. Cerebrovasc Dis. 2012;34:290-6. <h3>Disclosure of Interest</h3> None declared