Systemic inflammation in patients with inflammatory joint diseases does not influence statin dose needed to obtain LDL cholesterol goal in cardiovascular prevention

Rollefstad, Silvia; Ikdahl, Eirik; Hisdal, Jonny; Kvien, Tore K; Pedersen, Terje R.; Holme, Ingar; Semb, Anne Grete

doi:10.1136/annrheumdis-2013-204636

Cited by 18 publications

(9 citation statements)

References 39 publications

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“…As secondary prevention, the decrease in cholesterol with statins and relapse in MI are identical, regardless of whether or not the patients have RA, and discontinuing statins is accompanied by a high risk of stroke [32,33]. Finally, it was demonstrated that baseline systemic inflammation or lipid levels did not influence the dose of statin needed to reach LDLc target [34]. Strength of the study includes the application and the comparison of the 3 different guidelines in a specific RA population at very high or high total cardiovascular risk comparable to the risk in patients with diabetes, by introducing a 1.5 multiplication factor depending on RA characteristics.…”

Section: Discussionmentioning

confidence: 94%

Application of the European Society of Cardiology, Adult Treatment Panel III and American College of Cardiology/American Heart Association guidelines for cardiovascular risk management in a French cohort of rheumatoid arthritis

Tournadre¹,

Tatar²,

Pereira³

et al. 2015

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 94%

Application of the European Society of Cardiology, Adult Treatment Panel III and American College of Cardiology/American Heart Association guidelines for cardiovascular risk management in a French cohort of rheumatoid arthritis

Tournadre¹,

Tatar²,

Pereira³

et al. 2015

International Journal of Cardiology

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“…Patients with RA and AS were referred from a rheumatology outpatient clinic or from general practitioners, for CVD risk evaluation at the Preventive Cardio-Rheuma Clinic at Diakonhjemmet Hospital, Oslo, during the period March 2009–July 2012. Details concerning this preventive cardio-rheuma clinic and the approach to identify CVD risk factors, comorbidities, and biomarkers have been described previously ( 12 , 13 ). Referred patients received a CVD questionnaire by mail, including detailed questions regarding chest pain.…”

Section: Methodsmentioning

confidence: 99%

Association of Chest Pain and Risk of Cardiovascular Disease with Coronary Atherosclerosis in Patients with Inflammatory Joint Diseases

et al. 2015

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ObjectivesThe relation between chest pain and coronary atherosclerosis (CA) in patients with inflammatory joint diseases (IJD) has not been explored previously. Our aim was to evaluate the associations of the presence of chest pain and the predicted 10-year risk of cardiovascular disease (CVD) by use of several CVD risk algorithms, with CA verified by multidetector computed tomography (MDCT) coronary angiography.MethodsDetailed information concerning chest pain and CVD risk factors was obtained in 335 patients with rheumatoid arthritis and ankylosing spondylitis. In addition, 119 of these patients underwent MDCT coronary angiography.ResultsThirty-one percent of the patients (104/335) reported chest pain. Only six patients (1.8%) had atypical angina pectoris (pricking pain at rest). In 69 patients without chest pain, two thirds had CA, while in those who reported chest pain (n = 50), CA was present in 48.0%. In a logistic regression analysis, chest pain was not associated with CA (dependent variable) (p = 0.43). About 30% (Nagelkerke R2) of CA was explained by any of the CVD risk calculators: Systematic Coronary Risk Evaluation, Framingham Risk Score, or Reynolds Risk Score.ConclusionThe presence of chest pain was surprisingly infrequently reported in patients with IJD who were referred for a CVD risk evaluation. However, when present, chest pain was weakly associated with CA, in contrast to the predicted CVD risk by several risk calculators which was highly associated with the presence of CA. These findings suggest that clinicians treating patients with IJD should be alert of coronary atherosclerotic disease also in the absence of chest pain symptoms.

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“…Statins appear equally effective in patients with IJD 14. Furthermore, statins have anti-inflammatory properties and may thus induce an additional CV risk reduction when combined with anti-inflammatory therapy.…”

Section: Conventional CV Risk Factors In Ijdmentioning

confidence: 99%

Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders

Agca

Heslinga

Halm

et al. 2016

Heart

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Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care.

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Systemic inflammation in patients with inflammatory joint diseases does not influence statin dose needed to obtain LDL cholesterol goal in cardiovascular prevention

Cited by 18 publications

References 39 publications

Application of the European Society of Cardiology, Adult Treatment Panel III and American College of Cardiology/American Heart Association guidelines for cardiovascular risk management in a French cohort of rheumatoid arthritis

Application of the European Society of Cardiology, Adult Treatment Panel III and American College of Cardiology/American Heart Association guidelines for cardiovascular risk management in a French cohort of rheumatoid arthritis

Association of Chest Pain and Risk of Cardiovascular Disease with Coronary Atherosclerosis in Patients with Inflammatory Joint Diseases

Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders

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