title: Exploring cardiovascular disease risk evaluation in patients with inflammatory joint diseases.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) risk calculators developed for the general population have been shown to inaccurately predict CVD events in patients with inflammatory joint disease (IJD). European guidelines for CVD prevention recognize the presence of carotid plaques (CP) as a very high CVD risk factor, equivalent of coronary artery disease. Patients with IJD have a high prevalence of CP. We evaluated if CP resulted in reclassification of patients with IJD into a more appropriate CVD risk class and recommended lipid lowering treatment.
  
  
  METHODS
  CVD risk evaluation was performed in patients with IJD using SCORE and ACC/AHA risk calculators to predict CVD events.
  
  
  RESULTS
  Of the 335 IJD patients evaluated (including rheumatoid arthritis n=201, ankylosing spondylitis n=85 and psoriatic arthritis n=49), 183 and 159 IJD patients had a calculated CVD risk by SCORE and ACC/AHA <5%, indicating no need of lipid lowering treatment (LLT). However, of patients with low to moderate risk calculated by SCORE and ACC/AHA, 67 (36.6%) and 48 (30.2%) had CP and should according to guidelines receive intensive LLT. For patients with high risk, in the LLT considered group, 54.9% and 58.1% were reclassified to correct treatment when adding information on the presence of CP. Our results reveal a considerable reclassification into correct CVD risk category when adding CP in female patients.
  
  
  CONCLUSIONS
  The high frequency of asymptomatic atherosclerosis in patients with IJD has a notable impact on CVD risk stratification. Identification of CP will reclassify patients into recommended CVD preventive treatment group, which may be clinically important.
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Electronic address: a-semb@diakonsyk.no.
authors.forename: A G
authors.initials: AG
authors.lastname: Semb
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Ikdahl
authors.affiliation: Department of Vascular Medicine, Oslo University Hospital Aker, Oslo, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Hisdal
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: I C
authors.initials: IC
authors.lastname: Olsen
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Rollefstad
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: Cardiovascular disease; Inflammatory joint disease; Prevention; Risk factor