FRI0034 A LATIN-AMERICAN PREVENTIVE CARDIO-RHEUMA CLINIC: A CASE-CONTROL STUDY
2019
Background: It has been described an increased prevalence of cardiovascular diseases (CVD) in rheumatoid arthritis (RA) patients. When compared with the general population, CVD mortality is 50% higher in RA (1). It is reported a 35.3% prevalence of CVD in Latin-American population with RA (2). Cardio-rheuma (CR) clinics were designed to enhance detection, prevention and treatment of CVD in patients with rheumatic conditions. Our clinic located in the University Hospital in Monterrey Mexico, is the first and only established in Latin-America since 2014. Objectives: To describe the characteristics of patients with RA attending to a Latin-American CR clinic and compare the findings by carotid ultrasound (US) and echocardiography to controls. Methods: Cross-sectional, observational, comparative study. RA patients aged 40 to 75 years that fulfilled the 2010 EULAR criteria and matched controls were included. Patients with prior atherosclerotic CVD and overlap syndromes were excluded. Clinical history, blood samples, physical exam, carotid US and echocardiography were performed. Carotid plaque (CP) was defined as a focal narrowing ≥0.5 mm of the surrounding lumen or a carotid intima media thickness (cIMT) ≥1.2 mm, and increased cIMT was defined as ≥0.9 mm. Transthoracic echocardiogram was performed and reviewed by 2 board-certified cardiologists. Differences were solved by consensus. Categorical variables are expressed as total number (%), and numerical variables as median (q25-q75). Chi square and Mann-Whitney U-test were used to compare groups and considered significant if p Results: A total of 336 RA patients and 144 controls were included (Table 1). Table 2 summarizes echocardiographic and carotid US findings; ejection fraction was higher in controls than RA patients, prevalence of bilateral CP and increased cIMT was significantly higher in RA patients. Conclusion: RA patients from this clinic had lower ejection fraction, more prevalence of cIMT and bilateral CP when compared to controls. It is important that rheumatologists perform a complete evaluation of their patients, in which cardiovascular assessment should be included. References: [1] Avina-Zubieta JA, et al. 2008. Arthritis & Rheumatism. [2] Sarmiento-Monroy JC, et al. 2012. Hindawi Publishing Corporation. Disclosure of Interests: None declared
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