Page 100 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

CHAPTER 5
(ACR)/ European League Against Rheumatism (EULAR) 2010 criteria for RA(25). Patients were excluded if they had a diagnosis of crystal arthropathy, spondyloarthritis, osteoarthritis, systemic lupus erythematosus, Sjögren syndrome or infectious arthritis. Data came from patients included between November 2008 and July 2014. Approval was obtained from the local ethics committee (P0120, Ethics Committee of the Slotervaart Hospital and Reade, Amsterdam, the Netherlands), and all participating patients signed written informed consent according to the Declaration of Helsinki.
Patient characteristics.
At baseline, patients were interviewed to record details about symptom history, clinical characteristics, medication use and demographics, and underwent a physical examination. Follow-up data were collected after 52 weeks. Disease activity was measured with the Disease Activity Score of 28 joints (DAS28) and the EULAR response was determined(26). Physical examination included weight, height, blood pressure, ankle brachial index (ABI), and an electrocardiogram (ECG). Blood pressure was measured manually according to the standard hospital procedures. Blood sample measurements included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lipid profile, consisting of total cholesterol (TChol), triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL).
Treatment.
After the baseline visit, treatment could be initiated with methotrexate (MTX), prednisone, hydroxychloroquine (HCQ), sulfasalazine (SSZ), or a combination of these. Patients who used β-blockers or the calcium channel blockers verapamil or diltiazem, antihypertensive drugs or statins were excluded from analyses that involved conduction times, blood pressure, and cholesterol, respectively.
ECG details.
A standard resting 12-lead ECG was annually performed with the Mortara Eli 205C. Heart rate in bpm, QRS, QT, QTc and PQ time in milliseconds was recorded. All baseline ECG were reviewed by a cardiologist (JD) who was unaware of the patient characteristics. These disorders were noted: Atrioventricular block (AV), (incomplete) left bundle branch block (LBBB), (incomplete) right bundle branch block (RBBB), left anterior fascicular block (LAFB), left posterior fascicular block, a prolonged QTc time, and other intraventricular conduction disorders. A prolonged QTc time was defined as a QTc time of >450 milliseconds for men and >460 milliseconds for women.
Statistical analysis.
For descriptive purposes mean (SD), median (interquartile range (IQR)), or percentages were used, where appropriate. Independent Student t test was used for continuous variables with a normal distribution, and the nonparametric Mann-Whitney U test was used for continuous variables that had a skewed distribution. For dichotomous variables Pearson’s chi-square test was used. Fisher’s exact test was used with variables
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