Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: an international audit
Author:
Semb Anne GreteORCID, Rollefstad Silvia, Ikdahl Eirik, Wibetoe Grunde, Sexton Joseph, Crowson Cindy, van Riel Piet, Kitas George, Graham Ian, Rantapää-Dahlqvist Solbritt, Karpouzas George AthanasiosORCID, Myasoedova Elena, Gonzalez-Gay Miguel AORCID, Sfikakis Petros P, Tektonidou Maria GORCID, Lazarini Argyro, Vassilopoulos Dimitrios, Kuriya Bindee, Hitchon Carol, Stoenoiu Maria Simona, Durez PatrickORCID, Pascual-Ramos VirginiaORCID, Galarza-Delgado Dionicio AngelORCID, Faggiano Pompilio, Misra Durga PrasannaORCID, Borg Andrew A, Mu Rong, Mirrakhimov Erkin M, Gheta Diane, Douglas Karen, Agarwal VikasORCID, Myasoedova Svetlana, Krougly Lev, Valentinovna Popkova TatianaORCID, Tuchyňová Alena, Tomcik Michal, Vrablik Michal, Lastuvka Jiri, Horak Pavel, Medkova Helena Kaspar, Kerola Anne M
Abstract
AimThe objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention.MethodsThe cohort was derived from the Survey of Cardiovascular Disease Risk Factors in Patients with Rheumatoid Arthritis from 53 centres/19 countries/3 continents during 2014–2019. We evaluated the prevalence of cardiovascular disease (CVD) among RA-DM and RAwoDM. The study population was divided into those with and without ASCVD, and within these groups we compared risk factors and CVD preventive treatment between RA-DM and RAwoDM.ResultsThe study population comprised of 10 543 patients with RA, of whom 1381 (13%) had DM. ASCVD was present in 26.7% in RA-DM compared with 11.6% RAwoDM (p<0.001). The proportion of patients with a diagnosis of hypertension, hyperlipidaemia and use of lipid-lowering or antihypertensive agents was higher among RA-DM than RAwoDM (p<0.001 for all). The majority of patients with ASCVD did not reach the lipid goal of low-density lipoprotein cholesterol <1.8 mmol/L. The lipid goal attainment was statistically and clinically significantly higher in RA-DM compared with RAwoDM both for patients with and without ASCVD. The systolic BP target of <140 mm Hg was reached by the majority of patients, and there were no statistically nor clinically significant differences in attainment of BP targets between RA-DM and RAwoDM.ConclusionCVD preventive medication use and prevalence of ASCVD were higher in RA-DM than in RAwoDM, and lipid goals were also more frequently obtained in RA-DM. Lessons may be learnt from CVD prevention programmes in DM to clinically benefit patients with RA .
Funder
South Eastern Regional Health Authorities of Norway Eli Lilly and Company FOREUM
Subject
Immunology,Immunology and Allergy,Rheumatology
Cited by
13 articles.
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