Page 104 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

CHAPTER 5
factor (RF) or anticitrullinated protein antibodies (ACPA) positivity, pain visual analog scale (VAS) and BMI], no significant association was found (p = 0.36).
The systolic and diastolic blood pressures were associated with DAS28, ESR, and CRP levels (Supplementary Table 1). The mean (SD) ABI was 1.0 (0.1) and 16.0% of the patients had an ABI of < 0.9, and showed no association with conduction disorders.
Of the 417 patients without a statin, 9.1% had TChol of more than 6.5 mmol/l. TChol was not associated with the presence of a conduction disorder. Neither was the TChol:HDL ratio of which the mean (SD) was 4.0 (1.3). Patients with a high TChol (> 6.5 mmol/l), without statin or β-blocker, showed an association with QRS time. Patients with a high TChol had a mean QRS time of 97.8 (16.9), vs 93.4 (10.9) in the patients with normal cholesterol (p = 0.03). After correction for baseline demographics (DAS28, sex, age, symptom duration, RF, or ACPA positivity, VAS pain, and BMI) the same results were obtained [B: 5.38 (0.76-10.00), p = 0.02]. The same results were found when the patients with an RBBB were excluded (p = 0.01). TChol, HDL, and TChol:HDL ratio were significantly associated with disease activity (Supplementary Table 1).
Baseline versus Year 1 disease characteristics.
An ECG was done of 244 patients after 1 year. There were 236 patients who did not have a complete visit after 1 year. Reasons were remission (3), the patient moved (8), the patients had a different diagnosis (12), the patient did not want to participate anymore (27), death (2), the patient had a visit without ECG (119), and unknown (65). Baseline characteristics of the 244 patients with 1-year followup data compared with patients who did not have a complete visit after 1 year were comparable except for a small difference in DAS28 (SD) at baseline, 4.9 (1.3) vs 4.6 (1.5).
Of the 244 patients, 39 used a statin at baseline and/or after 1 year, 52 used antihypertensive drugs, and 16 used a β-blocker. After 1 year, DAS28, ESR, and CRP decreased significantly (Table 3). Regarding EULAR response, of the 244 patients, 58.9% had a good, 24.9% had a moderate one and 16.2% had none.
Table 3. Change in disease activity and conduction times in patients with 1-year followup data (n = 244). Data are mean (SD) unless otherwise indicated
Disease activity
CRP, mg/l, median (IQR)
ESR, mm/hour, median (IQR)
DAS28, median (IQR)
TJC 28, median (IQR)
SJC 28, median (IQR)
T=0
9.0 (2.0-20.0)
22.0 (10.0-38.0)
4.9 (1.3)
5.0 (3.0-10.0)
6.0 (4.0-9.0)
T=1 p
3.0 (1.0-6.0)
10.0 (4.0-19.0)
2.8 (1.2)
1.0 (0.0-3.0)
0.0 (0.0-2.0)
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
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