Page 121 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

Numbers are presented as frequency (percentage), mean (SD) or median [IQR]. ∆ Patients without cardiovascular events, n=97
‡ Patients without antihypertensives, n=88
† Patients without statins, n=99
* Statistical difference (p<0.05) between baseline and after four weeks
ACPA: anti-citrullinated protein antibody, BMI: body mass index, CRP: C-reactive protein, CV: cardiovascular, DAS: disease activity score, Dia RR: diastolic blood pressure, ESR: erythrocyte sedimentation rate, HAQ: health assessment questionnaire, HDL: high-density lipoprotein, IQR: interquartile range, LDL: low-density lipoprotein, RA: rheumatoid arthritis, RF: rheumatoid factor, SCORE: Systematic Coronary Risk Evaluation, SD: standard deviation, SJC: swollen joint count, Syst RR: systolic blood pressure, TC: total cholesterol, TJC: tender joint count, trigly: triglycerides, VAS: visual analogue scale
Cardiovascular risk score at baseline
At baseline median Dutch SCORE and Heart SCORE were 11.0% [3.5-23.5] and 0.0%
[0.0-1.5], respectively, see table 1. The correlation between absolute values of the
Dutch SCORE and Heart SCORE gave a spearman coefficient of 0.79 with a p-value of
<0.01. The agreement between the different risk categories (low, medium, high) was
62.4%, and gave a slight correlation (Ƙ=0.13, p<0.01). The Dutch risk model classified
29.9% of the patients as high risk, were the Heart SCORE risk model classified 3.1% of 6 the patients as high risk. Three patients (3.1%) had a high risk according to both the CV
risk models.
Of the 29 (29.9%) high CV risk patients according to the Dutch SCORE, 28 patients had an increased LDL and, according to the CV-RM guidelines, a statin indication. One patient already used a statin and thus needed dose optimization. Nineteen of the 29 patients had an increased SBP and therefore needed antihypertensive treatment, of those patients seven already had an antihypertensive, but needed dose optimization. In total all 29 high risk patients (29.9%) had an indication for (adaptations of) preventive treatment.
The change in cardiovascular risk score after four weeks
The number of patients that changed in CV risk category (low, medium, high) was not significantly different in both calculators. According to the Dutch SCORE nine (9.3%) patients switched from risk category, of which five patients went to a lower category and four patients to a higher category. In the Heart SCORE four (4.1%) patients changed from category, see figure 1.
The Dutch SCORE risk model showed that 31 (32.0%) patients were at high risk after four weeks. Twenty-seven (27.8%) patients had an increased LDL, thus an indication for statin treatment. Of the 27 patients, one already used a statin. Of the 31 patients, 13 (13.4%) patients had an increased blood pressure, thus in need of antihypertensive treatment of which five needed dose optimization.
CHANGE IN CARDIOVASCULAR RISK
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