title: 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.
abstract: 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.
  
  
  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-naïve 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 treatment was 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.
authors: CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: atournadre@chu-clermontferrand.fr.
authors: Anne
authors: A
authors: Tournadre
authors: CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: zkubandova@gmail.com.
authors: Zuzana
authors: Z
authors: Tatar
authors: CHU Clermont-Ferrand, Biostatistics Unit, France. Electronic address: bpereira@chu-clermontferrand.fr.
authors: Bruno
authors: B
authors: Pereira
authors: CHU Grenoble, Sud Hospital, Rheumatology Department, Grenoble, France. Electronic address: MChevreau@chu-grenoble.fr.
authors: Maxime
authors: M
authors: Chevreau
authors: Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, F-75013 Paris, France. Electronic address: laure.gossec@psl.aphp.fr.
authors: Laure
authors: L
authors: Gossec
authors: CHU Grenoble, Sud Hospital, Rheumatology Department, Grenoble, France. Electronic address: PGaudin@chu-grenoble.fr.
authors: Philippe
authors: P
authors: Gaudin
authors: CHU Clermont-Ferrand, Gabriel Montpied Hospital, Rheumatology Department, Clermont-Ferrand, France. Electronic address: msoubrier@chu-clermontferrand.fr.
authors: Martin
authors: M
authors: Soubrier
authors: Rhumatologie B, Cochin Hospital, Paris, France; René Descartes University, INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Rhumatologie B, Cochin Hospital, 27 rue du Fbg Saint-Jacques, Paris, France. Electronic address: maxime.dougados@cch.aphp.fr.
authors: Maxime
authors: M
authors: Dougados
mesh_terms: D000328:Adult; D000368:Aged; D000572:American Heart Association; D000596:Amino Acids / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology*; D002309:Cardiology / Q000379:methods / Q000592:standards*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015331:Cohort Studies; D050171:Dyslipidemias / Q000628:therapy; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012308:Risk Management; D014481:United States
chemical_list: D000596:Amino Acids; C013165:statine
keywords: Cardiovascular risk; Dyslipidemia; Rheumatoid arthritis; Statins