SAT0312 SUBCLINICAL ATHEROSCLEROSIS IN SYSTEMIC SCLEROSIS AND RHEUMATOID ARTHRITIS: A COMPARATIVE MATCHED-COHORT STUDY
Authors: P. Baniotopoulos, E. Pagkopoulou, S. Soulaidopoulos, A. Sandoo, N. Katsiki, A. Karagiannis, K. Douglas, A. Garyfallos, G. Kitas, T. Dimitroulas
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic autoimmune inflammatory disorders confer a higher risk of cardiovascular (CV) disease leading to increased morbidity and mortality compared to the general population. CV risk in Systemic Sclerosis (SSc) has not been studied so extensively as in other diseases, such as Rheumatoid Arthritis (RA), and the real impact of CV disease on SSc prognosis remains unknown. Surrogate markers of atherosclerosis namely carotid intima media thickness (cIMT) and pulse wave velocity (PWV) are impaired in some but not all studies in SSc patients. Objectives: The aim of the study was to investigate the prevalence of subclinical atherosclerosis assessed by cIMT and PWV between two well-characterized SSc and RA cohorts. Methods: Consecutive SSc patients attending the Scleroderma Clinic were compared with RA patients recruited in the Dudley Rheumatoid Arthritis Co-morbidity Cohort (DRACCO), a prospective study examining CV burden in RA. Cardiovascular risk was assessed using the QRisk3 and cIMT, Augmentation Index (AIx75) and central systolic and diastolic blood pressure were measured in all participants. Propensity score matching, was utilized to select patients from the two cohorts with similar demographic characteristics, CV risk factors (smoking, hypertension, obesity, dyslipidemia, diabetes) and inflammatory load. Unpaired t-test and Chi-square test of independence were applied. Results: Fifty five age- and sex-matched SSc and RA patients with similar distribution of CV risk factors were included. No difference was demonstrated between SSc and RA regarding cIMT and AIx75% (0.65 vs 0,61mm p=0,17 and 33.4 vs 31,7 p=0,397 respectively). However average QRisk3 score was significantly higher in the RA compared to the SSc group (P&lt;0.05). Conclusion: The results of this comparative study show that subclinical atherosclerosis is comparable between individuals with SSc and RA, a systemic disease with well-defined high atherosclerotic burden. RA patients have higher CV risk (QRisk3 algorithm) suggesting that disease-specific factors such chronic high-grade inflammation may influence the CV risk in this population. References: [1]Ozen G, et al. Subclinical Atherosclerosis in Systemic Sclerosis: Not Less Frequent Than Rheumatoid Arthritis and Not Detected With Cardiovascular Risk Indices. Arthritis Care Res (Hoboken) 2016; 68:1538-46 [2]Pagkopoulou E, et al., Cardiovascular risk in systemic sclerosis: Micro- and Macro-vascular involvement. Indian J Rheumatol 2017;12: 211-7 Table 1. Demographic and cardiovascular risk factors of the matched patients RA SSc P N=55 N=55 Age 63.6 (14.8) 61.3 (10.9) 0.140 Female 49 (89.1%) 53 (96.4%) 0.438 Smoking 10 (18.2%) 13 (23.6%) 0.5 Diabetes 0 (0.00%) 1 (1.82%) 0.364 Hyperlipidemia: 7 (12.7%) 6 (10.9%) 1.000 Hypertension: 23 (41.8%) 19 (34.5%) 0.441 ESRD 20.4 (18.4) 22.0 (19.1) 0.666 CRP 8.38 (11.6) 6.65 (30.2) 0.692 Table 2. Comparison of IMT, AIx75, Framingham and QRISK3 between matched patients RA SSc P N=55 N=55 IMT right average 0.65 (0.17) 0.61 (0.12) 0.175 IMT left average 0.67 (0.15) 0.64 (0.13) 0.214 IMT average 0.66 (0.14) 0.63 (0.10) 0.137 AIX 75% (%) 33.4 (9.23) 31.7 (10.8) 0.397 Framingham risk &lt; 0.001 &lt; 10% 9 (31.0%) 37 (74.0%) 10 – 20% 12 (41.4%) 9 (18.0%) 20 – 30% 3 (10.3%) 4 (8.00%) &gt;30% 5 (17.2%) 0 (0.00%) QRISK3 18.2 (15.3) 11.1 (10.6) 0.006 Disclosure of Interests: Pantelis Baniotopoulos: None declared, Eleni Pagkopoulou: None declared, Stergios Soulaidopoulos: None declared, Aamer Sandoo: None declared, Niki Katsiki: None declared, Asterios Karagiannis: None declared, Karen Douglas: None declared, Alexandros Garyfallos Grant/research support from: MSD, Aenorasis SA, Speakers bureau: MSD, Novartis, gsk, Georeg Kitas: None declared, Theodoros Dimitroulas: None declared