AB0394 Observational study of the incidence of cardiovascular events and associated comorbidities in a cohort of patients with recent onset rheumatoid arthritis. (12th June 2018) - Ortega Castro, R.
Abstract : Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main characteristic is persistent joint inflammation that results in joint damage and loss of function. and can involve other tissues and organs (extra-articular manifestations). 1 2 RA is associated with a high risk of morbidity and premature death secondary to the earlier development of cardiovascular, lung diseases and malignancy, being cardiovascular disease secondary to accelerated atherosclerosis the main cause of morbidity and mortality in these patients. 3 4 Objectives: Main objective: To calculate the incidence of comorbidities and CV events in patients with recent onset RA. Secondary objectives:-To determine the clinical disease features according to baseline RA profile. To analyse the relationship between CV event and the different variables. To describe classic CV risk factors evolution throughout the follow-up. Methods: We conducted a retrospective longitudinal observational study of 70 patients with recent onset RA according to ACR/EULAR 2010 or ACR 1987 criteria, at 5 years of follow-up.A descriptive study of the variables was carried out. For the bivariate analysis, the Chi-square test was used for the qualitative variables and the Mann Whitney U test for the independent quantitative ones. For the paired data, the McNemar test was used for the qualitative variables and T Student for the quantitative ones. A logistic regression model was used to associate the main variable with the rest of the variables. Finally, the analysis of survival and regression of COX was carried out. All the contrasts were bilateral and were considered significant when p<0.05 The statistical analysis was performed using SPSSV17. Results: The incidence of CV event was 18.57% (31% acute myocardial infarction). During follow-up, an improvement in inflammatory and quality of life parameters (DAS28, ESR, CRP and HAQ) was observed (p<0.05). Likewise, the% of hypertensive and dyslipidemic patients increased during follow up (p<0.05), while the levels of cholesterol, triglycerides, glucose and diabetic patients remained similar. The presence of CV event was related to high levels of ESR, male sex and hypertension, (p<0.05). Conclusions: The incidence of cardiovascular event in our recent onset RA cohort resembles that previously described in the literature, with the majority occurring during the first 5 years of follow–up. The development of hypertension and dyslipidemia occurs mainly during the first 5 years of follow–up. The presence of a cardiovascular event was related to male sex, high blood pressure and high ESR levels. References: [1] McInnes IB, Schett G. The Pathogenesis of Rheumatoid Arthritis. N Engl J Med2011;365(23):2205–19. [2] Mielants H, Van den Bosch F. Extra-articular manifestations. Clin Exp Rheumatology2009;27(Suppl 55):S56–S61. [3] Nurmohamed MT. Cardiovascular risk in rheumatoid arthritis. Autoimmunity Reviews2009;8:663–7. [4] del Rincón ID, Williams K, Stern MP, Freeman GL, Escalante A. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum2001;44(12):2737–45. Disclosure of Interest: None declared