AB0196 AGE, BIOLOGIC SEX AND DISEASE TYPE INFLUENCE THE CARDIOVASCULAR BURDEN IN PATIENTS WITH INFLAMMATORY ARTHRITIS AT DISEASE ONSET
Authors: A. Alunno, F. Mai, G. Baldini, F. Bellisario, F. Santilli, C. Martini, V. Moronti, J. Santilli, E. Campanozzi, F. M. Mariani, C. Ferri, F. Carubbi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Cardiovascular (CV) morbidity and mortality severely impact the quality of life and prognosis of patients with inflammatory arthritis. A large bulk of data is available in patients with rheumatoid arthritis (RA) whereas studies in spondyloarthritis (SpA) are fewer and the CV burden at disease onset is not characterised in detail. <h3>Objectives:</h3> To assess the CV burden in patients with inflammatory arthritis (RA or SpA) at the time of disease diagnosis. <h3>Methods:</h3> Newly diagnosed patients with SpA or RA fulfilling the 2009 ASAS or the 2016 RA classification criteria respectively and with full CV assessment at baseline have been recruited. Age-matched individuals without RA or SpA from a National publicly available database of the Ministry of Health were enrolled as controls. <h3>Results:</h3> Of 443 eligible patients, a preliminary analysis on 201 patients (105 SpA and 95 RA) was performed and the control group included 8718 age-matched healthy individuals. Arterial hypertension was more prevalent in patients than controls [odds ratio (OR) and 95% confidence interval (CI): 1.7; 1.3-2.3] whereas obesity, hypercholesterolemia and smoking habit were comparable. Hypertriglyceridemia and type 2 diabetes mellitus were less frequent in patients than controls (OR and 95% CI 0.42; 95% 0.3-0.6 and 0.22; 0.12-0.39 respectively). Nonetheless, the overall proportion of previous acute coronary syndromes (ACS) and cerebrovascular events was higher in patients than controls (7% vs 2.8%). 75% of cerebrovascular events in patients occurred before 65 years of age. When performing a sub-analysis by disease, biologic sex and age the following data emerged: i. The pattern of CV risk factors prevalence in the overall cohort was similar also in SpA vs RA and females vs males. ii. We observed a higher risk of ACS in all patients compared to HC and this resulted from a higher risk in both RA and SpA but regarding biologic sex a higher risk was evident only in males (Figure 1). iii. We observed a trend for higher risk of stroke in all patients and this resulted from a higher risk in RA but regarding biologic sex a higher risk was evident only in females (Figure 2). iv. The prevalence of CV risk factors increased with age, however up to 50% of younger patients (&lt;45 years of age) already showed at least one CV risk factor. These were mainly males with either SpA or RA in equal proportion. No differences in the clinical or serological presentation (e.g., axial vs peripheral PsA or seropositive vs seronegative RA) was observed between young patients with or without CV risk factors. However younger patients with SpA and CV risk factors showed higher disease activity scores and more frequently abnormal C-reactive protein values than those without CV risk factors. <h3>Conclusion:</h3> Our results show that not only patients with RA but also patients with SpA have a consistent CV burden since disease onset even at young age. The different risk for CV events across subpopulations based on disease type and biologic sex should guide preventive CV strategies and CV risk monitoring to ultimately build tailored and optimised approaches. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>