Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: an international audit. Issue 2 (8th July 2021)

• Record Type: Journal Article
• Authors: Semb, Anne Grete; Rollefstad, Silvia; Ikdahl, Eirik; Wibetoe, Grunde; Sexton, Joseph; Crowson, Cindy; van Riel, Piet; Kitas, George; Graham, Ian; Rantapää-Dahlqvist, Solbritt; Karpouzas, George Athanasios; Myasoedova, Elena; Gonzalez-Gay, Miguel A; Sfikakis, Petros P; Tektonidou, Maria G G; Lazarini, Argyro; Vassilopoulos, Dimitrios; Kuriya, Bindee; Hitchon, Carol; Stoenoiu, Maria Simona; Durez, Patrick; Pascual-Ramos, Virginia; Galarza-Delgado, Dionicio Angel; Faggiano, Pompilio; Misra, Durga Prasanna; Borg, Andrew A; Mu, Rong; Mirrakhimov, Erkin M; Gheta, Diane; Douglas, Karen; Agarwal, Vikas; Myasoedova, Svetlana; Krougly, Lev; Valentinovna Popkova, Tatiana; Tuchyňová, Alena; Tomcik, Michal; Vrablik, Michal; Lastuvka, Jiri; Horak, Pavel; Medkova, Helena Kaspar; Kerola, Anne M;
• Is Part Of: RMD open. Volume 7:Issue 2(2021)
• Publication Date: 2021-07-08
• Subjects: arthritis -- rheumatoid -- hypertension -- lipids -- cardiovascular diseases -- atherosclerosis; Musculoskeletal system -- Diseases -- Periodicals; Rheumatism -- Periodicals; 616.7005
• DOI: 10.1136/rmdopen-2021-001724
• Languages: English
• ISSNs: 2056-5933

Abstract

Abstract : Aim: The objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention. Methods: The cohort was derived from the Survey of Cardiovascular Disease Risk Factors in Patients with Rheumatoid Arthritis from 53 centres/19 countries/3 continents during 2014–2019. We evaluated the prevalence of cardiovascular disease (CVD) among RA-DM and RAwoDM. The study population was divided into those with and without ASCVD, and within these groups we compared risk factors and CVD preventive treatment between RA-DM and RAwoDM. Results: The study population comprised of 10 543 patients with RA, of whom 1381 (13%) had DM. ASCVD was present in 26.7% in RA-DM compared with 11.6% RAwoDM (p<0.001). The proportion of patients with a diagnosis of hypertension, hyperlipidaemia and use of lipid-lowering or antihypertensive agents was higher among RA-DM than RAwoDM (p<0.001 for all). The majority of patients with ASCVD did not reach the lipid goal of low-density lipoprotein cholesterol <1.8 mmol/L. The lipid goal attainment was statistically and clinically significantly higher in RA-DM compared with RAwoDM both for patients with and without ASCVD. The systolic BP target of <140 mm Hg was reached by the majority of patients, and there were no statistically nor clinically significant differences in attainment of BP targets between RA-DM and RAwoDM. Conclusion: CVD preventive medication use and prevalence of ASCVD were higher in RA-DM than in RAwoDM, and lipid goals were also more frequently obtained in RA-DM. Lessons may be learnt from CVD prevention programmes in DM to clinically benefit patients with RA .