Ten-year risk of cardiovascular complications in patients with rheumatoid arthritis

• Published in: Terapevtic̆eskii arhiv Vol. 83; no. 5; pp. 14 - 19
• Main Authors: Gerasimova, E V, Popkova, T V, Novikova, D S, Aleksandrova, E N, Novikov, A A, Nasonov, E L
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 01-01-2011
• Subjects: Adult; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - immunology; c-reactive protein; C-Reactive Protein - metabolism; cardiovascular complications; cardiovascular disease risk factors; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Disease Progression; Female; Follow-Up Studies; Humans; Immunity, Innate; Incidence; Male; Middle Aged; Nephelometry and Turbidimetry; Prognosis; Retrospective Studies; rheumatoid arthritis; Risk Factors; Russia - epidemiology; Time Factors; Russia
• ISSN: 0040-3660; 2309-5342

To compare 10-year risk of cardiovascular complications (CVC) assessed by Adult Treatment Panel III (ATP III) and Reynolds Risk Score (RRS); to specify contribution of C-reactive protein (CRP) to development of CVC in patients with rheumatoid arthritis (RA).
The trial included 116 RA patients (100 females and 16 males) and 85 healthy subjects (63 females and 22 males) under 55 years of age free of clinical symptoms of cardiovascular diseases. RA duration and activity were the same in men and women. The patients and controls were matched by age, incidence of standard risk factors (RF). The 10-year risk of CVC development was estimated by two scales--ATP III and RRS. Total cholesterin, HDLP cholesterin were measured with standard enzyme tests, concentration of CRP was assessed by highly sensitive immune nephelometry.
The 10-year risk of CVC was higher in RA patients both by ATP III (1.8 - 1;10%) and RRS (2.6 - 2; 7)% compared to the controls (1 - 1;3)% and (1.2 - 1;4)% (p < 0.05). In male RA patients RRS is higher than in females - 7 (3.5; 12)% and 2 (1;2)%, respectively (p < 0.001). Re-calculation from the scale ATP III to RRS has changed the risk in 17 (17%) females and 7 (44%) males with RA. As a result, the number of RA patients with a low CVC risk decreased, with a moderate risk rose 2 times, with a high risk was the same. RRS dependence on the disease duration, RA activity (DAS28) was not registered. RA patients showed a positive correlation of RRS with thickness of the intima-media complex of the carotid arteries (r = 0.44; p < 0.001).
Introduction of a new prognostic scale RRS allows isolation of groups of patients with moderate and high CVC risk and timely medication of such patients.