E75. PATIENTS WITH PSORIATIC ARTHRITIS ARE AT HIGH RISK OF MYOCARDIAL INFARCTION/CARDIOVASCULAR DISEASE ACCORDING TO QRISK2

Abstract

Background: Increased cardiovascular (CV) risk is well documented in rheumatoid arthritis (RA). Annual reviews, including assessment of CV risk, are well established and part of NICE (National Institute for Health and Clinical Excellence). There is evidence of increased CV risk in other inflammatory arthritides. This survey focusses on Psoriatic Arthritis (PsA), as part of our annual review. Our previous survey showed that a high proportion of patients with PsA have modifiable CV risk factors. This survey aimed to explore this risk in more detail. Method(s): A retrospective survey was conducted of all PsA patients, seen in the Hospitals' Nurse Practitioner clinic (April 2015-6). The data were compared with previous results. On the most recent survey, Chi Square analysis was used on the QRISK2 validated algorithm for CV risk assessment. This calculated a 10 year CV risk. Result(s): 37 patients with PsA were surveyed, all were white and British. Mean age 56.8. We identified the following elevated CV risk factors: hypertension 2 (5%), enlarged waist circumference 30 (81%) Increased BMI 32 (86%), smokers 3 (8%), increased alcohol intake 1(3%) and 18 (49%) no cardiac exercise. Cholesterol/HDL ratios for 24 patients - 13 (54%) had a high ratio. A QRISK2 calculation was performed, which calculates a 10 year CVD risk with or without PsA being considered as an equivalent risk factor to RA. The CVD risk is still higher than anticipated for the normal population even without considering PsA as a comparable risk to RA. This assessment showed a high proportion of patients had a QRISK2 >10% and should be considered for treatment. If PsA is included as an equivalent to RA, the proportion increases even further (significantly greater by Chi Square analysis). Conclusion(s): There is prior evidence that CVD risk is elevated in PsA. These data show that in our cohort this risk is largely due to increased BMI, enlarged waist size and dyslipidaemia. In this survey the risk of CVD in PsA appears as great as those with RA. When using QRISK2 to identify CVD risk, PsA should be considered as the equivalent of RA in the calculations.