AB0208 Unfavourable cardiovascular risk profile in male patients with rheumatoid arthritis of low disease activity
Authors: B. Targonska-Stepniak, M. Biskup, M. Majdan
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) is associated with the increased cardiovascular (CV) morbidity and mortality, mostly due to accelerating atherosclerosis. Both traditional and non-traditional factors seem to contribute to the excess of CV risk. Data in literature indicate a positive association between RA activity and the extent of CV disease (CVD) risk, suggesting a dominant effect of systemic inflammation. It is reported, that low disease activity is sufficient to achieve a protective effect against CVD and that atherosclerosis is not accelerated in RA of low activity or remission. <h3>Objectives</h3> The goal of the study was to assess CV parameters in female and male patients with RA of low disease activity in comparison with healthy controls. <h3>Methods</h3> The study was conducted in 70 patients with low RA activity, without known CVD (54 women, 16 men) and 33 healthy volunteers (18 women, 15 men). Patients underwent standard physical examination, assessment of disease activity in 28 joints (DAS28) and laboratory measurements including amino-terminal pro-brain natriuretic peptide (NT-proBNP). The following procedures were performed both in RA patients and controls: blood pressure (BP), carotid intima media thickness (cIMT), electrocardiography (ECG) and echocardiography with assessment of ejection fraction (EF) and diastolic dysfunction (E/A ratio). <h3>Results</h3> The significant differences between male vs female RA patients included: higher mean values of cIMT [0,93 (0,19) vs 0,80 (0,22) mm, p=0,04], atherogenic index [4,2 (1,4) vs 3,5 (1,0), p=0,03] and SCORE [5,7 (3,7) vs 2,8 (2,7), p&lt;0001]; as well as lower concentration of HDL-cholesterol [(50,2 (12) vs 59<sup>14,6</sup> mg/dl, p=0,04] and NT-proBNP [66,6 (61,2) vs 106,8 (61,5) pg/ml, p=0006]. The mean values of age, disease duration, DAS28, C-reactive protein, body mass index, BP, QTc, E/A and EF were not significantly different in male and female patients with RA of low activity. In the control group no significant differences were observed between male and female subjects, when considering: age, cIMT, BP, QTc, EF, E/A. All the male RA patients had features of subclinical or advanced atherosclerosis (cIMT ≥0.6 mm), there were no male patients with normal cIMT (&lt;0,6 mm). In controls normal cIMT was found in 5 (33,3%) and subclinical atherosclerosis in 10 (66,7%), there was no control subject with advanced atherosclerosis (p=0,01). The mean age of patients and controls did not differ significantly. <h3>Conclusions</h3> The results of the study suggest an unfavourable CV risk profile in male RA patients with low disease activity. The higher CV risk was observed in male RA patients in comparison with both controls of comparable age, as well as with female RA patients of comparable age, disease duration and activity. It seems that the male gender contributes considerably to CV risk in the period of low RA activity. <h3>Disclosure of Interest</h3> None declared