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

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:183

Article

Tournadre, Anne¹  Tatar, Zuzana¹  Pereira, Bruno²  Chevreau, Maxime³  Gossec, Laure⁴  Gaudin, Philippe³  Soubrier, Martin¹  Dougados, Maxime^5,6 

[1] CHU Clermont Ferrand, Gabriel Montpied Hosp, Dept Rheumatol, Clermont Ferrand, France

[2] CHU Clermont Ferrand, Biostat Unit, Clermont Ferrand, France

[3] CHU Grenoble, Sud Hosp, Dept Rheumatol, F-38043 Grenoble, France

[4] Univ Paris 06, Sorbonne Univ, Inst Pierre Louis Epidemiol & Sante Publ, Pitie Salpetriere Hosp,AP HP,Dept Rheumatol, F-75013 Paris, France

[5] Cochin Hosp, Rhumatol B, Paris, France

[6] Univ Paris 05, INSERM, U1153,Cochin Hosp,Rhumatol B, Clin Epidemiol & Biostat,PRES Sorbonne Paris Cite, Paris, France

关键词: Rheumatoid arthritis;    Cardiovascular risk;    Dyslipidemia;    Statins;   

DOI  :  10.1016/j.ijcard.2015.01.069

来源: Elsevier

【 摘 要 】

Background: Patients with rheumatoid arthritis (RA) have greater rates of cardiovascular mortality and RA is an independent cardiovascular risk factor. For the management of cholesterol, the American College of Cardiology/American Heart Association (ACC/AHA) developed new guidelines for the general population. None of the European or American guidelines are specific to RA. The European League Against Rheumatism (EULAR) recommends applying a coefficient to cardiovascular risk equations based on the characteristics of RA. Our objective was to compare the three different sets of guidelines for the eligibility of statin therapy in RA-specific population with very high risk of cardiovascular disease. Methods and results: We calculated the proportion of patients eligible for statins according to the guidelines of the European Society of Cardiology (ESC), the Adult Treatment Panel III (ATP-III) and the ACC/AHA in a French cohort of statin-naive RA patients at least 40 years age. Of the 547 women and 130 men analyzed, statins would be recommended for 9.1% of the women and 26.4% of the men, 15.6% of the women and 53.1% of the men, 38.8% of the women and 78.5% of the men, according to the ESC, ATP-III and ACC/AHA guidelines respectively. Conclusions: In RA patients, as has been observed in the general population, discordance in risk assessment and cholesterol treatmentwas observed between the three sets of guidelines. The use of the new ACC/AHA guidelines would expand the eligibility for statins and may be applied to RA population a condition at very high risk of cardiovascular disease. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

【 授权许可】

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