FRI0087 Regional age- and sex-specific intima-media thickness criteria in young patients with rheumatoid arthritis

Abstract

Background Rheumatoid arthritis (RA) is associated with early progression of cardiovascular (CV) diseases. The CV risk calculators had been verified on a specific population1 and should be applied predominantly for them. Systematic COronary Risk Evaluation (SCORE) was recommended by EULAR for use in RA patients with multiplying coefficient 1,5.2 Nevertheless, SCORE don’t consider RA-specific factors and couldn’t be used in young patient. For timely prevention additional criteria is needed to evaluate CV risk in RA-patents. A presence of atherosclerotic plaque (APl) or intima-media thickening, assessed by carotid ultrasonography, may be used as a high CV risk marker after adjustment by age and sex factors. Objectives To investigate the prevalence of carotid intima-media thickening, using regional age- and sex-specific criteria. Methods One hundred forty eight Caucasian patients with RA (age – 53 years;40; 60 DAS28 5.01 [3.91; 5.90]) without (APl) were included in our study. Patients had ACR-defined RA (1987 classification criteria). All patients gave written informed consent before enrollment. SCORE with multiplying coefficient 1.5 was used for the CV risk determining. Range of atherosclerotic progression was assessed by ultrasonography with measurement of carotid intima-media thickness (IMT). IMT measured had been compared with ranges followed:<35/35–44/45–54/55–64/65–74/>75 age – 0,55/0,72/0,72/0,80/0,86/1,0 mm for the right artery and 0,53/0,65/0,73/0,85/0,89/1,0 mm for the left one (men); 0,47/0,51/0,71/0,78/0,87/0,87/0,87 mm for the right artery and 0,50/0,55/0,71/0,80/0,91/0,98 for the left one (women), respectively.3 Descriptive statistics, Chi-squared test, Spearman rank correlation coefficient were used for data analysis. Results are presented as median and 25th/75th percentiles (Me [25th percentile; 75th percentile]. Results IMT significantly correlated with age (ρ=0,63; p<0,001), systolic blood pressure (ρ=0,22; p=0,017), but not with other parameters (sex, smoking, cholesterol, etc). Risk was evaluated by SCORE for 109 RA patients elder than 40 years (age – 57 years50; 63) and was 0%>15% (1.95% [0.75; 3.15]). An intima-media thickening had been revealed in 86 from 109 (78,9%) patients and correlated with SCORE value (ρ=0,42; p<0,001). 34 patients (23.0%) were younger than 40 years (age – 30.5 years28,0; 36,0), therefore the relative CV risk scale had been used for ones. Risk evaluated was medium (1.5%–3%) for all young patient. An intima-media thickening had been revealed in 31 from 34 (91.2%) patients and didn’t correlate with SCORE value (ρ=0.37; p=0.104). Number of patients with carotid thickening between two groups didn’t significantly difference (p=0.13). Conclusions Using age- and sex-specific criteria for the IMT evaluation may be useful in young patients with RA. References [1] Conroy RM, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur. Heart J. 2003;24(11):987–1003. [2] Lunzer R. 2016updated EULAR evidence-based recommendations for the management of gout. J. fur Miner2016;23(3):108. [3] Malyutina S. K., et al. Sex- and age-specific reference criteria of carotid arteries intima-media thickness in typically Russian population. Ultrasonic and functional diagnostics2015;(5S):107b. Disclosure of Interest None declared