THU0436 ASSESSMENT OF CARDIOVASCULAR RISK LEVELS IN CPPD VERSUS RA AND GOUT, AND RISK-FLUCTUATION ANALYSIS BASED ON CALCULATOR TYPE: ATP III AND REYNOLDS RISK SCORE
Authors: A. Novikova, M. Elisеev, O. Sheliabina, H. Gerasimova
Journal: Annals of the Rheumatic Diseases (2020)

Background: Cardiovascular risk in CPPD patients is not so well evaluated as in other rheumatic diseases, and optimal risk calculators for patients with calcium pyrophosphate crystal deposition disease have not yet been studied. Objectives: To assess CVR and compare stratification results using АТР III and Reynolds Risk Score (RRS) calculators in CPPD, RA and gout patients versus the control subjects. Methods: The case-control study included 168 patients aged 18 - 80 years old, with 42 participants in each subgroup – CPPD, gout, RA patients and healthy volunteers, matched by gender (10 males and 32 females) and age (mean age 54 years). CPPD diagnosis was based on McCarty 1961 y criteria, RA – following ACR/EULAR 2010 y criteria, and gout - ACR/EULAR 2015 criteria. CPPD and gout diagnosis was crystal- verified in all cases. Exclusion criteria were as follows: diabetes mellitus and eGFR&lt;60 ml/min/1.73m 2 . The following data was collected for all patients: anthropometric parameters, BP, lab tests, including serum glucose level, creatinine, total cholesterol (TC), HDLp, CRP; CVR was assessed using АТР III and RRS scales. Statistica 12.0 package was used for statistical data processing. Results: Both groups were comparable in terms of anthropometric parameters, rates of individual indicators and factors did not differ, except for family history of cardiovascular disease, systolic BP, HDLp, hsCRP (see Table). Table 1. Risk factors and CVR stratification by ATP III and RRS in CPPD, RA, gout and control group. CPPD (n=42) RA (n=42) Gout (n=42) Control (n=42) Smoking, n (%) 11 (26,2) 12 (28,6) 8 (19,0) 12 (28,6) Systolic BP, mmHg, M±SD 124±14* / ** 138±17 ## 144±26 ### 127±16 TC, mg/dl, M±SD 261.9±64.2 244.1±77.5 249.3±62.7 244.1±52.6 HDLp, mg/dl, M±SD 63.2±20.2* / ** 49.2±16.5 ## 52.0±9.7 ### 58.1±16.4 hsCRP, mg/l, Me [25-75 th percentiles] 3.8 [1,0;12,4] * / ** / *** 8,6 [4.1;20.6] ## 8.5 [4.1;2.9] ### 1,5[0.8;2.6] hsCRP ≥5 mg/l, n (%) 18 (43)* / ** / *** 27 (64) ## 29 (69) ### 3 (7) Family history of CVD, n % 6 (14)* / *** 16 (38) # 4 (10) ### 17 (40) High and very high CVR levels, ATP III scale (&gt;10%), n (%) 5 (12) 9 (21) 7 (17) 8 (19) High and very high CVR levels, RRS scale (&gt;10%), n (%) 9 (21) 14 (33) 12 (29) 7 (17) *p&lt;0.05 between CPPD and RA, **р&lt;0.05 between CPPD and gout, ***р&lt;0.05 between CPPD and controls, # р&lt;0.05 between RA and gout, ## р&lt;0.05 between RA and controls, ### р&lt;0.05 between gout and controls. Based on ATP III risk calculation the number of CPPD patients with high and very high CVR was 5 (12%) patients and was close to that in RA (9(21%)), gout (7 (17%)) and the control group (8 (19%)). Mean CRP levels and number of pts with CRP ≥5 mg/l were significantly lower in CPPD and control group pts, than in RA and gout, however CRP ≥5 mg/l levels were documented almost in half of CPPD pts (43%) and only in 7% of pts from the control group ( р &lt;0.05). Although CVR calculations based on RRS scale yielded similar results, and all groups remained comparable, nevertheless, the number of pts with high and very high CVR increased in each group, except for the control. There were no meaningful differences in between the groups in TC levels, however HDLp was significantly higher in CPPD pts ( p &lt;0.05), than in RA and gout, and in the control group pts vs RA pts ( p &lt;0.05). Conclusion: CPPD associated cardiovascular risk is considerably high and comparable to CVR levels in RA and gout. Given that RRS based CVR calculation resulted in increased number of patients with high and very high risks in all groups, except for the control group, it can be suggested that use of calculators including CRP is appropriate not only in RA pts, but also in microcrystal deposition arthritis, associated with inflammation, therefore prospective studies on larger samples are deemed necessary. Disclosure of Interests: : Aleksandra Novikova: None declared, Maxim Elisеev Speakers bureau: Novartis, Menarini Group, Alium, Olga Sheliabina: None declared, Helen Gerasimova: None declared