THU0127 Estimated cardiovascular risk in a large cohort of rheumatoid arthritis patients from the “Cardiovascular Obesity and Rheumatic DISease (CORDIS)” Study Group of the Italian Society of Rheumatology.
Authors: F. Cacciapaglia, M. Piga, G. Erre, A. Manfredi, E. Bartoloni Bocci, G. Sakellariou, O. Viapiana, S. Colella, A. Abbruzzese, M. Dessì, C. Vacchi, F. Castagna, G. Cafaro, B. L. Palermo, A. Giollo, M. Fornaro, E. Gremese, F. R. Spinelli, F. Atzeni
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rheumatoid arthritis (RA) patients present high cardiovascular (CV) morbidity and mortality and EULAR recommends estimating their CV-risk [1]. The Systematic Coronary Risk Evaluation (SCORE) algorithm is suggested if National Guidelines are lack, but few data are available about different strategies. Objectives: To estimate the 10-years CV-risk using different algorithms in RA compared to osteoarthritis (OA) patients, as control group. Methods: A total of 1467 RA patients (78.3% female; mean age 59.8±11.5 years; mean disease duration 131±109 months), fulfilling the 2010 EULAR/ACR classification criteria, and 342 age and sex matched patients with OA (79.8% female; mean age 58.7±11.5 years) were enrolled in this multicentre cross-sectional study during 2019. Clinical and laboratory data were registered, and individual CV-risk was calculated using: SCORE chart, “Progetto Cuore” model (PCM), QRisk3, Reynolds Risk Scores (RRS) and Expanded Risk Score in RA (ERS-RA), as stated by suitable algorithms. Statistical analysis was performed using the Statistical System Graphpad Instat 8.0 (San Diego, CA-USA). Results: In 46 (3%) RA patients a previous CV event was observed. Among traditional CV-risk factors, RA patients presented higher frequency of diabetes (9.9% vs 6.4%; p=0.04) and lower prevalence of dyslipidaemia (21.7% vs 32.5%; p&lt;0.0001) compared to OA patients. Prevalence of hypertension was similar in both groups (40% vs 39.2%). Mean BMI (25.6±4.8 vs 26.6±4.4; p&lt;0.0001) and prevalence of obesity (15% vs 21%; p=0.003) were significantly lower in RA patients. Finally, RA patients were more frequently smokers (20.4% vs 12.5% - p=0.002). 441 (30%) RA patients were in CDAI remission, 998 (68%) patients were on csDMARDs while a biologic agent was used in 617 (42%) patients. About 43% of RA patients were on a mean prednisone-dose of 4.5±3.5 mg/day. The 10-years CV-risk resulted 2 to 3-fold higher in RA compared to OA patients using the different algorithms. The QRisk3 estimated the highest CV risk in our cohort of patients, while the ERS-RA and RRS were significantly higher than PCM and SCORE. Conclusion: Our study demonstrates a higher estimated CV-risk in RA compared to OA patients. The commonly used algorithms to estimate CV-risk in clinical practice perform differently, evaluating different traditional CV-risk factors and disease specific characteristic, as for QRisk3 or ERS-RA. Rheumatologist should impact on both traditional and RA related modifiable CV-risk factors. References: [1]Agca R, et al. Ann Rheum Dis 2017;76:17–28. Disclosure of Interests: Fabio Cacciapaglia Speakers bureau: BMS; Roche; Pfizer; Abbvie, Matteo Piga: None declared, Gianluca Erre: None declared, Andreina Manfredi: None declared, Elena Bartoloni Bocci: None declared, Garifallia Sakellariou Speakers bureau: Abbvie, Novartis, MSD, Ombretta Viapiana: None declared, Sergio Colella: None declared, Anna Abbruzzese: None declared, Martina Dessì: None declared, Caterina Vacchi: None declared, Floriana Castagna: None declared, Giacomo Cafaro: None declared, Bianca Lucia Palermo: None declared, Alessandro GIollo: None declared, Marco Fornaro: None declared, Elisa Gremese Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp &amp; Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp &amp; Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Francesca Romana Spinelli Grant/research support from: Pfizer, Speakers bureau: Lilly, BMS, Celgene, Fabiola Atzeni: None declared