SAT0091 SURVEY OF CARDIOVASCULAR DISEASE AND RISK FACTOR MANAGEMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS ACROSS 5 WORLD REGIONS: RESULTS FROM THE SURF-RA
Authors: A. G. Semb, E. Ikdahl, J. Sexton, G. Kitas, P. Van Riel, C. S. Crowson, I. Graham, S. Rollefstad
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with rheumatoid arthritis (RA) are at high risk for cardiovascular disease (CVD). Observational data suggest a need for improved risk factor recording and management in such subjects. Objectives: The aim of this survey was to evaluate updated information on CVD risk factors, comorbidities, RA and CVD preventive medication in patient with RA. Methods: The audit is termed SU rvey of cardiovascular disease R isk F actors in patients with R heumatoid A rthritis (SURF-RA) and was performed in 53 centres in 19 countries across 5 world regions during 2014 and 2019. SURF-RA is part of the SURF family of audits which have been performed in patients with CHD, in primary care 2 , and now in patients with stroke and SLE. Data including demographics, RA disease characteristics, CVD, risk factors and medications was collected. The survey was approved by the Data Protection Officer (2017/7243) and a General Data Protection evaluation has been performed (10/10-2018). Results: Among 14 503 patients with RA in West (n= 8 493) and East (n=923) Europe, Latin (n=407) and North (n=4030) America and Asia (n=650) the mean (SD) age was 59.9 (13.6) years, and 2/3 or more were female (table). RA disease duration was comparable across the world regions, ranging from 9.9 to 12.6 years. The average disease activity was low [disease activity score including 28 joints and C-reactive protein; DAS28CRP: mean (SD): 2.6 (1.2)]. The prevalence of atherosclerotic CVD (ASCVD) was lowest in Latin America (2.5%) and highest in East Europe (21.4%), and this pattern was similar regarding familial premature CVD. The mean prevalence (% of each entity) of blood pressure above 140/90 mmHg was 5.3%, of low density lipoprotein cholesterol &gt; 2.5 mmol/L: 63.3%. Overall, 29% used anti-hypertensive medication, lowest in West Europe (17.4%) and highest in East Europe (57.0%), and 26.4% used lipid lowering agent(s), lowest in Asia (7.2%) and highest in North America (31.1%). Body mass index &gt; 30 kg/m2 was present in 26.6%, with the smallest waist circumference in Asia [mean (SD): 84.1 (13.6) cm] and highest in East Europe [92.5 (15.5) cm]. The proportion of current smokers was on average: 16.2 %, lowest in Asia (7.8%) and highest in East Europe (28.5%). Conclusion: The high prevalence of CVD risk factors and ASCVD in patients with RA across five world regions shows that there is still an unmet need for vigilance and improved implementation of preventive measures in this high CVD risk patient population. References: [1] Cooney MTet al. SURF-Survey of Risk Factor management: First report of an international audit. Eur J Prev cardiol 2014 [2] Zao M, Cooney MT, Klipstein-Grobush K, et al. Simplifying the audit of risk factor recording and control: A report from an international study in 11 countries. Eur J Prev Cardiol 2016 All West Europe East Europe Latin America North America Asia p-value Number of patients 14503 8493 923 407 4030 650 Age mean(SD) 59.8 (13.6) 60.7 (13.2) 58.8 (11.8) 52.8 (11.6) 59.4 (14.8) 55.7 (13.1) &lt;0.001 Sex female (%) 74.5 74.1 78.5 92.4 72.2 77.3 Disease duration (yrs) mean(SD) 10.8 (9.5) 10.5 (9.5) 12.1 (9.3) 9.9 (7.5) 12.6 (9.8) 10.5 (9.8) &lt;0.001 DAS28-CRP mean(SD) 2.6 (1.2) 2.5 (1.1) 2.9 (1.2) 2.8 (1.3) 2.8 (1.2) 2.8 (1.4) &lt;0.001 Atherosclerotic CVD (%) 13.3 11.4 21.4 2.5 16.2 10.3 &lt;0.001 Lipid lowering medication (%) 26.4 25.1 28.5 22.4 31.1 7.2 &lt;0.001 Any anti-hypertensive (%) 29.0 17.4 57.0 24.8 46.8 31.8 &lt;0.001 Disclosure of Interests: Anne Grete Semb: None declared, Eirik Ikdahl: None declared, Joe Sexton: None declared, Georeg Kitas: None declared, Piet van Riel: None declared, Cynthia S. Crowson Grant/research support from: Pfizer research grant, Ian Graham: None declared, Silvia Rollefstad: None declared