Ab0240 rheumatoid arthritis clinical activity is not associated to cardiovascular risk as measured by traditional risk scales

Background Rheumatoid arthritis (RA) patients have a higher cardiovascular risk (CVR) than the general population, being atherosclerotic cardiovascular disease the main cause of mortality [1]. Such increased could be explained by traditional CVR factors and chronic inflammatory state of disease. Clinical activity of disease, which is evaluated by DAS-28, is a parameter that denotes the current inflammatory status. [2] Objectives To compare CVR, by six scales: ACC/AHA ASCVD 2013, Framingham lipids and BMI, SCORE2, QRISK3 and Reynolds risk score, according to clinical activity of RA patients using DAS-28 CRP. Methods Descriptive, comparative and cross-sectional study. We enrolled RA patients between 40 and 75 years old who fulfilled ACR/EULAR 2010 classification criteria and recruited in the Rheumatology service from a tertiary care hospital, in Monterrey, Mexico. Patients were divided by time of disease evolution into quartiles. CVR results from scales were multiplied by 1.5 factor according to EULAR 2016 recommendation. Normality was assesed by Kolmogorov-Smirnov test. Variables with a non-normal distribution were described by median and interquartile range (p25-p75). Differences between groups was analyzed by Kruskal-Wallis test or Chi-squared, accordingly. Results A total of 377 RA patients were included. Demographic characteristic are shown in Table 1. An increased in acute phase reactants, CRP (p= 0.000) and ESR (p= 0.003) was found, as severity of clinical activity increased, meanwhile CVR did not show significative changes, regardless of which of scales it was measured by. Conclusion CVR did not increase according to clinical activity of RA, which suggests that such severity can not explain by itself the increased in risk showed in this population. References [1] England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: Mechanisms and implications. BMJ (Online). 2018;361. [2] Solomon DH, Reed GW, Kremer JM, Curtis JR, Farkouh ME, Harrold LR, et al. Disease Activity in Rheumatoid Arthritis and the Risk of Cardiovascular Events. Arthritis & Rheumatology. 2015 Jun;67(6):1449–55. Table 1. Demographic characteristics (n= 377) Variable Remisión (n= 121) Low activity (n=51) Moderate activity (n=156) High activity (n=49) p Duration of disease, years. median (p25-p75) 7.0 (3.0-14.0) 7.9 (2.7-14.9) 7.0 (3.0-15.4) 5.1 (1.6-12.9) NS Women, (n)% 103 (85) 47 (92) 149 (95) 49 (100) 0.002 Age, years. median (p25-p75) 57 (49-62) 53 (48-63) 54 (48-59) 55 (45-58) NS BMI, kg/m2. median (p25-p75) 27.2 (25.0-30.4) 26.7 (24.7-30.8) 28.0 (24.6-31.8) 28.4 (24.7-32.3) NS Laboratory tests, median (p25-p75 ) CPR, mg/dL. 0.5 (0.2-0.9) 0.7 (0.3-1.4) 0.9 (0.4-1.6) 1.2 (0.6-2.9) 0.000 ESR, mm/H. 22.0 (15.0-32.5) 23.0 (16.0-41.0) 28.0 (18.0-42.0) 30.0 (18.0-56.0) 0.003 ACPA, U/mL. 99.8 (2.6-199.1) 23.2 (1.4-195.5) 44.9 (1.1-198.7) 7.6 (1.2-191.3) NS RF IgG, U/mL. 4.3 (2.0-12.2) 4.6 (2.0-11.5) 4.8 (2.0-16.0) 3.2 (2.0-9.9) NS RF IgM, U/mL. 200.0 (38.0-200.0) 200.0 (35.4-200.0) 200.0 (56.7-200.0) 160.1 (20.4-200.0) NS RF IgA, U/mL. 75.6 (11.3-200.0) 68.8 (7.0-200.0) 47.4 (6.6-197.1) 68.1 (2.8-200.0) NS Cardiovascular risk scores, %. median ASCVD 4.8 2.8 2.6 3.1 NS FRS-Lipids 8.8 7.6 7.3 7.8 NS FRS-BMI 12.5 11.1 9.3 11.1 NS SCORE 2 6 4.5 4.5 4.5 NS Q-RISK III 6.1 5.3 4.5 5.7 NS RRS 1.5 1.5 1.5 1.5 NS This table shows demographic and clinical characteristics. BMI Body Mass Index; CRP C Reactive Protein; ESR Erythrocyte Sedimentation Rate; ACPA Anti–Citrullinated Protein Antibody; RF Rheumatoid Factor; ASCVD Atheroesclerotic Cardiovascular Disease; FRS Framingham Risk Score; RRS Reynolds Risk Score; SCORE 2 Systematic Coronary Risk Evaluation 2. Acknowledgements: NIL. Disclosure of Interests None Declared.