AB1317 Identification of cardiometabolic abnormalities in the first visit to a preventive cardio-rheuma clinic
Authors: D.A. Galarza-Delgado, J.R. Azpiri-López, I.J. Colunga-Pedraza, E.E. Abundis-Márquez, J.A. Dávila-Jiménez, A.H. Guillén-Lozoya, R. Vera-Pineda, J.A. Cárdenas-de la Garza, A. Martínez-Moreno, R.I. Arvizu-Rivera, R.E. Ramos-Cázares
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic, systemic and autoimmune disease with articular and extra-articular manifestations. RA is associated with increased prevalence of comorbidities and higher cardiovascular risk when compared to general population. Atherosclerotic cardiovascular (CV) events are the leading cause of death in RA. In a recent meta-analysis, hypertension, type 2 diabetes mellitus (T2DM) and hypercholesterolemia were shown to increase the risk of CV disease in this population.<sup>1</sup> A study reported a prevalence of hypertension 29.8%; dyslipidemia 27.1% and T2DM 12.4% in Mexican-mestizo RA patients.<sup>2</sup> The cardio-rheuma clinics were designed to provide healthcare for CV diseases in patients with rheumatic conditions. Specific guidelines recommendations have been published to enhance detection and management of specific comorbidities associated to RA.<sup>3</sup> <h3>Objectives</h3> To identify the prevalence of unknown cardiometabolic risk factors in a Mexican-mestizo cohort with RA. <h3>Methods</h3> Cross-sectional, observational study. Patients who fulfilled the 1987 ACR and/or the 2010 ACR/EULAR classification criteria were consecutively recruited. Patients were divided in two groups, with and without history of cardiovascular comorbidities. Clinical history and physical exam were performed by a general physician in a cardio-rheuma clinic. Fasting blood glucose and lipid profile were performed on all subjects. Categorical variables are expressed as percentages and numerical variables as means±standard deviations. <h3>Results</h3> A total of 296 patients were included. Demographical characteristics are shown in Figure 1. Hypertension was the most frequent comorbidity (27.7%), followed by dyslipidemia (26.7%) and T2DM (13.5%). Many of the patients without history of cardiometabolic risk factor had important findings on baseline visit: 18.7% had altered blood pressure without history of hypertension, 76.5% had an abnormal lipid profile without history of dyslipidemia, and 21.5% had an altered fasting glucose without history of T2DM. *Altered lipid profile was defined as TC ≥200 mg/dL, HDL-C &lt;50 mg/dL, TG ≥150 mg/dL, LDL-C ≥100 mg/dL. SD=Standard deviation; T2DM=Type 2 diabetes mellitus; bDMARDs=biological agents; DAS 28-CRP=Disease Activity Score 28 joints C-reactive protein. <h3>Conclusions</h3> In our cohort of Mexican-mestizo RA patients there is a high prevalence of cardiometabolic risk factors. An important amount of these were discovered in patients without previous diagnosis at their first visit to a cardio-rheuma clinic. <h3>References</h3> [1] Dougados, et al. (2014). Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Annals of the rheumatic diseases, 73(1), 62–68. [2] Galarza-Delgado, et al. (2017). Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis. Rheumatology international, 37(9), 1507–1511. [3] Perk, J., et al. (2012). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Atherosclerosis, 223(1), 1–68. <h3>Acknowledgements</h3> None <h3>Disclosure of Interest</h3> None declared