AB0309 Lipid-lowering intervention of a preventive cardio-rheuma clinic in mexican mestizo patients with rheumatoid arthritis
Authors: DΆ Galarza-Delgado, JR Azpiri-Lόpez, IJ Colunga-Pedraza, RE Ramos-Cázares, FJ Torres-Quintanilla, A Valdovinos-Bañuelos, RI Arvizu-Rivera, A Martínez-Moreno, JA Cárdenas-de la Garza, R Vera-Pineda, J García-Colunga, MA Garza-Elizondo, G Elizondo-Riojas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) have a significantly increased risk for cardiovascular (CV) morbidity and mortality when compared to general population (1). Preventive cardio-rheuma clinics have been created in recent years and proven to be effective to manage CV risk in patients with inflammatory joint diseases around the world (2). <h3>Objectives</h3> To evaluate the need for lipid-lowering intervention in Mexican mestizo patients with RA. <h3>Methods</h3> We initiated a preventive cardio-rheuma clinic for appropriate CV disease prevention in patients with RA in our population. A complete evaluation and CV risk stratification was performed to our patients, including blood tests and ultrasound examination of both carotid arteries. Each patient was classified to lifestyle changes only, a lifestyle intervention plus lipid-lowering treatment, or to have a low risk with no need for intervention, in accordance to the 2012 European Guidelines on cardiovascular disease prevention in clinical practice and the 2016 ESC/EAS Guidelines for the Management of Dyslipidemias. <h3>Results</h3> A total of 100 patients were evaluated, patient characteristics and intervention group distribution are shown in Table 1. Among these patients, 49 were found not to need any lipid-lowering intervention. The remaining 51 were classified into lifestyle change (n=18, 35.3%) or lipid-lowering drug regimens (n=33, 64.7%). A significant difference between intervention groups was only found regarding age (p&lt;0.001). A multiple regression analysis was performed to predict the kind of intervention needed from age, disease duration, disease activity and autoantibody levels, only age added statistically significantly to the prediction (p&lt;0.001). <h3>Conclusions</h3> There was indication for preventive intervention in more than half of our patients. Age is a determinant factor that increases CV risk in RA patients independently from disease-specific factors. Treatment to lipid targets is essential to reduce their risk of CV morbidity and mortality (3). A prospective study evaluating treatment success rate is needed to further evaluate the intervention of the clinic. <h3>References</h3> Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, et al. Comparison of statin eligibility according to the Adult Treatment Panel III, ACC/AHA blood cholesterol guideline, and presence of carotid plaque by ultrasound in Mexican mestizo patients with rheumatoid arthritis. Clin Rheumatol. 2016;35(11):2823–7. Rollefstad S, Kvien TK, Holme I, et al. Treatment to lipid targets in patients with inflammatory joint diseases in a preventive cardio-rheuma clinic. Ann Rheum Dis. 2013;72(12):1968–74. Rollefstad S, Ikdahl E, Hisdal J, Olsen IC, et al. Rosuvastatin-Induced Carotid Plaque Regression in Patients With Inflammatory Joint Diseases: The Rosuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and Other Inflammatory Joint Diseases Study. Arthritis Rheumatol. 2015;67(7):1718–28. <h3>Disclosure of Interest</h3> None declared