Page 123 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

(Components of) Cardiovascular risk scores and the association with disease activity
The DAS44 of all patients improved during follow-up. Lipid levels increased during treatment, especially HDL, which resulted in a decrease in TC:HDL ratio from 3.9 (1.3) at baseline to 3.2 (1.0) after four weeks of anti-rheumatic treatment. The mean blood pressure decreased with 3 mmHg for systolic and 2 mmHg for diastolic blood pressure (Table 1).
The results of the tobit mixed model analyses relating disease activity with CV risk scores were inconclusive. A higher DAS44 was associated with a lower CV risk score, which showed a stronger effect after four weeks. However, the presence of a higher ESR and CRP had no effect at baseline and were after four weeks related with higher CV risk scores (Table 2).
The linear mixed model analyses relating disease activity with the separated components of the CV risk scores showed that a higher DAS44 was associated with lower lipid levels, and an increase in TC:HDL ratio, especially at baseline. For ESR and CRP comparable results were observed. The association between disease activity and blood pressure gave inconclusive results (Table 3).
Table 2. Mean effect over time for baseline and week four values, between disease activity 6 and cardiovascular risk scores (with interaction with the time)
CHANGE IN CARDIOVASCULAR RISK
Dutch SCORE HeartSCORE
Beta (CI)
DAS44 -0.09 (-0.90-0.71)
-0.91 (-1.93-0.12)
SJC 0.01 (-0.13-0.15)
-0.04 (-0.35-0.27)
ESR 1.02 (-0.02-0.05)
-0.02 (-0.12-0.09)
CRP 0.00 (-0.03-0.04)
0.09 (-0.04-0.21)
p-value Beta (CI)
0.819* -0.32 (-0.77-0.13)
0.084 -0.70 (-1.38- -0.02)
0.887 -0.01 (-0.08-0.07)
0.802 -0.07 (-0.27-0.13)
0.364 0.00 (-0.01-0.02) 0.769 0.02 (-0.01-0.05)
0.852 0.00 (-0.02-0.02)
0.184 0.02 (-0.01-0.05)
p-value
0.158
0.041
0.873
0.488
0.656
0.244
0.858
0.232
CI: confidence interval, CRP: C-reactive protein, DAS: disease activity score, ESR: erythrocyte sedimentation rate, SJC: swollen joint count
Grey values: values after four weeks of treatment
* interaction with time p<0.10
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