title: Cardiovascular morbidity and associated risk factors in Spanish patients with chronic inflammatory rheumatic diseases attending rheumatology clinics: Baseline data of the CARMA Project.
abstract: OBJECTIVE
  To establish the cardiovascular (CV) morbidity and associated risk factors for CV disease (CVD) in Spanish patients with chronic inflammatory rheumatic diseases (CIRD) and unexposed individuals attending rheumatology clinics.
  
  
  METHODS
  Analysis of data from the baseline visit of a 10-year prospective study [CARdiovascular in rheuMAtology (CARMA) project] that includes a cohort of patients with CIRD [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)] and another cohort of matched individuals without CIRD attending outpatient rheumatology clinics from 67 hospitals in Spain. Prevalence of CV morbidity, CV risk factors, and systematic coronary risk evaluation (SCORE) assessment were analyzed.
  
  
  RESULTS
  A total of 2234 patients (775 RA, 738 AS, and 721 PsA) and 677 unexposed subjects were included. Patients had low disease activity at the time of recruitment. PsA patients had more commonly classic CV risk factors and metabolic syndrome features than did the remaining individuals. The prevalence of CVD was higher in RA (10.5%) than in AS (7.6%), PsA (7.2%), and unexposed individuals (6.4%). A multivariate analysis adjusted for the presence of classic CV risk factors and disease duration revealed a positive trend for CVD in RA (OR = 1.58; 95% CI: 0.90-2.76; p = 0.10) and AS (OR = 1.77; 95% CI: 0.96-3.27; p = 0.07). Disease duration in all CIRD groups and functional capacity (HAQ) in RA were associated with an increased risk of CVD (OR = 2.15; 95% CI: 1.29-3.56; p = 0.003). Most patients had a moderate CV risk according to the SCORE charts.
  
  
  CONCLUSIONS
  Despite recent advances in the management of CIRD, incidence of CVD remains increased in Spanish subjects with CIRD attending outpatient rheumatology clinics.
authors.affiliation: Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain.
authors.forename: Santos
authors.initials: S
authors.lastname: Castañeda
authors.affiliation: Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: María A
authors.initials: MA
authors.lastname: Martín-Martínez
authors.affiliation: Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.affiliation: Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.affiliation: Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: García-Yébenes
authors.affiliation: Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: Sabina
authors.initials: S
authors.lastname: Pérez-Vicente
authors.affiliation: Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
authors.forename: Jesús T
authors.initials: JT
authors.lastname: Sánchez-Costa
authors.affiliation: Research Unit of Spanish Society of Rheumatology, Madrid, Spain; School of Medicine, Universidad de La Laguna, La Laguna, Tenerife, Spain; Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Díaz-Gonzalez
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain. Electronic address: miguelaggay@hotmail.com.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology*; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013167:Spondylitis, Ankylosing / Q000453:epidemiology*; D013997:Time Factors
keywords: Ankylosing spondylitis; Cardiovascular morbidity; Cardiovascular risk; Psoriatic arthritis; Rheumatoid arthritis