Assessment of cardiovascular risk in patients with rheumatoid arthritis using the SCORE risk index.
BACKGROUND
Rheumatoid arthritis is an autoimmune disease that causes systemic involvement and is associated with increased risk of cardiovascular disease.


OBJECTIVE
To analyze the prediction index of 10-year risk of a fatal cardiovascular disease event in female RA patients versus controls.


METHODS
Case-control study with analysis of 100 female patients matched for age and gender versus 100 patients in the control group. For the prediction of 10-year risk of a fatal cardiovascular disease event, the SCORE and modified SCORE (mSCORE) risk indexes were used, as suggested by EULAR, in the subgroup with two or more of the following: duration of disease ≥10 years, RF and/or anti-CCP positivity, and extra-articular manifestations.


RESULTS
The prevalence of analyzed comorbidities was similar in RA patients compared with the control group (p>0.05). The means of the SCORE risk index in RA patients and in the control group were 1.99 (SD: 1.89) and 1.56 (SD: 1.87) (p=0.06), respectively. The means of mSCORE index in RA patients and in the control group were 2.84 (SD=2.86) and 1.56 (SD=1.87) (p=0.001), respectively. By using the SCORE risk index, 11% of RA patients were classified as of high risk, and with the use of mSCORE risk index, 36% were at high risk (p<0.001).


CONCLUSIONS
The SCORE risk index is similar in both groups, but with the application of the mSCORE index, we recognized that RA patients have a higher 10-year risk of a fatal cardiovascular disease event, and this reinforces the importance of factors inherent to the disease not measured in the SCORE risk index, but considered in mSCORE risk index.
Discipline of Rheumatology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil.
Otávio Augusto Martins
OA
de Campos
Department of Epidemiology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil.
Nazaré Otília
NO
Nazário
Nucleus of Rheumatology, Teaching Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Sônia Cristina
SC
de Magalhães Souza Fialho
Nucleus of Cardiology, Teaching Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Guilherme Loureiro
GL
Fialho
Discipline of Rheumatology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil.
Fernando José Savóia
FJ
de Oliveira
Discipline of Rheumatology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil; Nucleus of Rheumatology, Hospital Governador Celso Ramos de Florianópolis, Florianópolis, SC, Brazil.
Gláucio Ricardo Werner
GR
de Castro
Discipline of Rheumatology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil; Nucleus of Rheumatology, Hospital Governador Celso Ramos de Florianópolis, Florianópolis, SC, Brazil. Electronic address: ivanioreumato@gmail.com.
Ivânio Alves
IA
Pereira
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002319:Cardiovascular System; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index
Artrite reumatoide; Cardiovascular events; Cardiovascular risk; Eventos vasculares; Fatores de risco; Rheumatoid arthritis; Risco cardiovascular; Risk factors