Cardiovascular disease risk profiles in inflammatory joint disease entities

Wibetoe, Grunde; Ikdahl, Eirik; Rollefstad, Silvia; Olsen, I.C.; Bergsmark, Kjetil; Kvien, Tore K; Salberg, Anne; Soldal, D.M.; Bakland, Gunnstein; Lexberg, Åse Stavland; Fevang, Bjørg‐Tilde Svanes; Gulseth, H.C.; Haugeberg, Glenn; Semb, Anne Grete

doi:10.1186/s13075-017-1358-1

Cited by 47 publications

(43 citation statements)

References 39 publications

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“…Data on the CVD risk profiles, risk estimations and CVD risk factor treatment in the NOCAR project have already been published and are available elsewhere. 24–26 …”

Section: Resultsmentioning

confidence: 99%

Feasibility of cardiovascular disease risk assessments in rheumatology outpatient clinics: experiences from the nationwide NOCAR project

Ikdahl¹,

Rollefstad²,

Wibetoe³

et al. 2018

RMD Open

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ObjectiveThe European League Against Rheumatism recommends implementing cardiovascular disease (CVD) risk assessments for patients with inflammatory joint diseases (IJDs) into clinical practice. Our goal was to design a structured programme for CVD risk assessments to be implemented into routine rheumatology outpatient clinic visits.MethodsThe NOrwegian Collaboration on Atherosclerosis in patients with Rheumatic joint diseases (NOCAR) started in April 2014 as a quality assurance project including 11 Norwegian rheumatology clinics. CVD risk factors were recorded by adding lipids to routine laboratory tests, self-reporting of CVD risk factors and blood pressure measurements along with the clinical joint examination. The patients’ CVD risks, calculated by the European CVD risk equation SCORE, were evaluated by the rheumatologist. Patients with high or very high CVD risk were referred to their primary care physician for initiation of CVD preventive measures.ResultsData collection (autumn 2015) showed that five of the NOCAR centres had implemented CVD risk assessments. There were 8789 patients eligible for CVD risk evaluation (rheumatoid arthritis (RA), 4483; ankylosing spondylitis (AS), 1663; psoriatic arthritis (PsA), 1928; unspecified and other forms of spondyloarthropathies (SpA), 715) of whom 41.4 % received a CVD risk assessment (RA, 44.7%; AS, 43.4%; PsA, 36.3%; SpA, 30.6%). Considerable differences existed in the proportions of patients receiving CVD risk evaluations across the NOCAR centres.ConclusionPatients with IJD represent a patient group with a high CVD burden that seldom undergoes CVD risk assessments. The NOCAR project lifted the offer of CVD risk evaluation to over 40% in this high-risk patient population.

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“…Data on the CVD risk profiles, risk estimations and CVD risk factor treatment in the NOCAR project have already been published and are available elsewhere. 24–26 …”

Section: Resultsmentioning

confidence: 99%

Feasibility of cardiovascular disease risk assessments in rheumatology outpatient clinics: experiences from the nationwide NOCAR project

Ikdahl¹,

Rollefstad²,

Wibetoe³

et al. 2018

RMD Open

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“…Spondyloarthritis (SpA) encompasses a number of related inflammatory conditions, characterized by considerable overlap in clinical features reflecting their shared genetic susceptibility and pathophysiology (1)(2)(3)(4)(5)(6)(7). In common with other chronic inflammatory diseases such as rheumatoid arthritis (RA), SpA is associated with an increased risk of cardiovascular comorbidity and increased mortality when compared to the general population (8)(9)(10). This association is incorporated in treatment guidelines, with specific recommendations to monitor and prevent cardiovascular disease (11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Hypertension Associated with Spondyloarthritis Disease Duration: Results from the ASAS-COMOSPA Study

Derakhshan¹,

Goodson²,

Packham³

et al. 2019

J Rheumatol

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Objective.Spondyloarthritis (SpA) is associated with a number of cardiovascular (CV) comorbidities. We examined the association of SpA disease duration and delay in diagnosis with CV-related conditions.Methods.Using data from the COMOSPA study, the associations between SpA disease duration and CV-related conditions were evaluated in univariable and multivariable logistic regression models. Each model examined 1 CV-related factor as dependent and “SpA disease duration” as a predictor, adjusted for relevant confounders.Results.Data from 3923 subjects (median SpA disease duration 5.1 yrs, interquartile range 1.3–11.8 yrs) were available for analysis. The main CV-related conditions were hypertension (HTN; 22.4%), ischemic heart disease (2.6%), stroke (1.3%), and diabetes mellitus (5.5%). HTN was associated with SpA disease duration in both univariable and multivariable analysis, with an OR of 1.129 (95% CI 1.072–1.189; p < 0.001) for each 5-year increase in SpA disease duration. Other factors associated with HTN were age, male sex, current body mass index, ever steroid therapy, and ever synthetic disease-modifying antirheumatic drug therapy, but not nonsteroidal antiinflammatory drugs (NSAID). In subgroup analysis, the strongest association of HTN and disease duration was seen in subjects with the axial-only SpA phenotype (OR 1.202, 95% CI 1.053–1.372) but not in those with peripheral-only SpA (OR 0.902, 95% CI 0.760–1.070). The other CV conditions were not associated with SpA disease duration.Conclusion.Duration of SpA disease in the ASAS-COMOSPA cohort is associated with higher odds of HTN, particularly in those with axial disease, but not with other CV-related conditions. The association with HTN does not appear to be related to NSAID exposure.

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“…Patients with SPA have a higher prevalence of CVD, and have a significant increase in traditional CVD risk factors including hypertension, hyperlipidemia as well as obesity [59][60][61]. For patients with PSA, the risk of major cardiac events is increased for those not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), suggesting that either disease severity or activity may also increase cardiac risk in PSA [62].…”

Section: Major Acute Cardiac Eventsmentioning

confidence: 99%

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

Goodman

Bass

2018

BMC Rheumatol

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Total hip (THA) and total knee arthroplasty (TKA) are widely used, successful procedures for symptomatic end stage arthritis of the hips or knees, but patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) are at higher risk for adverse events after surgery. Utilization rates of THA and TKA remain high for patients with RA, and rates of arthroplasty have increased for patients with SLE and SPA. However, complications such as infection are increased for patients with SLE, RA, and SPA, most of whom are receiving potent immunosuppressant medications and glucocorticoids at the time of surgery. Patients with SLE and AS are also at increased risk for perioperative cardiac and venous thromboembolism (VTE), while RA patients do not have an increase in perioperative cardiac or VTE risk, despite an overall increase in VTE and cardiac disease. This narrative review will discuss the areas of heightened risk for patients with RA, SLE, and SPA, and the perioperative management strategies currently used to minimize the risks.

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Cardiovascular disease risk profiles in inflammatory joint disease entities

Cited by 47 publications

References 39 publications

Feasibility of cardiovascular disease risk assessments in rheumatology outpatient clinics: experiences from the nationwide NOCAR project

Feasibility of cardiovascular disease risk assessments in rheumatology outpatient clinics: experiences from the nationwide NOCAR project

Increased Risk of Hypertension Associated with Spondyloarthritis Disease Duration: Results from the ASAS-COMOSPA Study

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

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