TY - JOUR
T1 - C-reactive protein and 10-year cardiovascular risk in rheumatoid arthritis
AU - Erre, Gian Luca
AU - Cacciapaglia, Fabio
AU - Sakellariou, Garifallia
AU - Manfredi, Andreina
AU - Bartoloni, Elena
AU - Viapiana, Ombretta
AU - Fornaro, Marco
AU - Cauli, Alberto
AU - Mangoni, Arduino Aleksander
AU - Woodman, Richard John
AU - Palermo, Bianca Lucia
AU - Gremese, Elisa
AU - Cafaro, Giacomo
AU - Nucera, Valeria
AU - Vacchi, Caterina
AU - Spinelli, Francesca Romana
AU - Atzeni, Fabiola
AU - Piga, Matteo
AU - “Cardiovascular, Obesity and Rheumatic Disease Study (CORDIS) Group” of the Italian Society of Rheumatology (SIR)
PY - 2022/10
Y1 - 2022/10
N2 - Objectives: To evaluate the association between C-reactive protein (CRP) and 10-year risk of cardiovascular (CV) events using the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA), based on conventional and RA-specific risk factors but not CRP, in RA patients without previous cardiovascular events.Methods: ERS-RA was calculated in 1,251 “Cardiovascular Obesity and Rheumatic Disease Study (CORDIS)” database patients [(age 60.4(9.3) years; 78% female; disease duration, 11.6(8) years; CDAI, 9(9); CRP, 6.8(12) mg/L]. Results: The mean (SD) 10-year risk of CV events was 12.9% (10). After adjusting for the use of DMARDs and biologics, CRP concentrations were significantly associated with 10-year risk of CV events (coefficient=0.005 for each 10 mg/L CRP increment; 95%CI 0.000–0.111; p = 0.047). In mediation analysis, the association between CRP and ERS-RA was not explained by disease activity.Conclusion: In a large cohort of RA patients without previous cardiovascular events, a 20 mg/L increase in CRP concentrations was associated with a 1% increase in 10-year risk of CV events. This suggests that actively targeting residual inflammatory risk beyond conventional and RA-specific risk factors might further reduce CV event rates in RA patients.
AB - Objectives: To evaluate the association between C-reactive protein (CRP) and 10-year risk of cardiovascular (CV) events using the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA), based on conventional and RA-specific risk factors but not CRP, in RA patients without previous cardiovascular events.Methods: ERS-RA was calculated in 1,251 “Cardiovascular Obesity and Rheumatic Disease Study (CORDIS)” database patients [(age 60.4(9.3) years; 78% female; disease duration, 11.6(8) years; CDAI, 9(9); CRP, 6.8(12) mg/L]. Results: The mean (SD) 10-year risk of CV events was 12.9% (10). After adjusting for the use of DMARDs and biologics, CRP concentrations were significantly associated with 10-year risk of CV events (coefficient=0.005 for each 10 mg/L CRP increment; 95%CI 0.000–0.111; p = 0.047). In mediation analysis, the association between CRP and ERS-RA was not explained by disease activity.Conclusion: In a large cohort of RA patients without previous cardiovascular events, a 20 mg/L increase in CRP concentrations was associated with a 1% increase in 10-year risk of CV events. This suggests that actively targeting residual inflammatory risk beyond conventional and RA-specific risk factors might further reduce CV event rates in RA patients.
KW - C-reactive protein
KW - Cardiovascular risk score
KW - Inflammation
KW - Myocardial infarction
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85133767149&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2022.07.001
DO - 10.1016/j.ejim.2022.07.001
M3 - Article
AN - SCOPUS:85133767149
SN - 0953-6205
VL - 104
SP - 49
EP - 54
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -
