OP0027 APPLICATION OF PREVENTIVE CV RISK STRATEGIES FOR DYSLIPIDEMIA IN RHEUMATOID ARTHRITIS PATIENTS: DATA FROM THE CARDIOVASCULAR OBESITY AND RHEUMATIC DISEASES (CORDIS) STUDY GROUP OF THE ITALIAN SOCIETY OF RHEUMATOLOGY

Abstract

BackgroundRheumatoid arthritis (RA) patients are at high risk for atherosclerotic cardiovascular disease (CVD) and mortality, and dyslipidemia represents a modifiable CV risk factor significantly contributing to the increased risk. However, dyslipidemia is frequently underestimated and inadequately managed in rheumatologic clinical practice.ObjectivesThe aim of the present study was to investigate how dyslipidemia in RA patients is managed in a real-life setting for primary prevention strategies.MethodsA cross-sectional study of RA patients of the Cardiovascular Obesity and Rheumatic DISeases (CORDIS) cohort [1], with no previous CVD and with available lipid levels was performed. All patients were stratified by the Systematic COronary Risk Evaluation (SCORE) algorithm for CV risk [2] and the application of primary preventive strategy was assessed in accordance with the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for the management of dyslipidaemias [3].ResultsA total of 1296 RA patients (79% females) with a mean age of 59±12 years were included. According to the SCORE algorithm, 457 (35.5%) patients were at moderate CV risk (1-5%), 455 (35.1%) at high CV risk (5-10%), and 384 (29.6%) at very high (>10%) CV risk. None was at low CV risk (<1%). Eighty percent of the whole cohort was eligible for statin therapy, but only 22.3% was on treatment at inclusion, and 38.2% presented lipid levels on target. Among patients at high and/or very-high SCORE risk, 70% were not on statin treatment even if recommended and 26.7% were not at lipid target even if under statin use. Among patients at moderate SCORE risk, 208 (45.5%) were at lipid target and 31(14.9%) of them were on statin therapy. Globally 565 (43.6%) patients were not on treatment for dyslipidemia even if recommended according to ESC/EAS guidelines (Figure 1). Of note, about 80% of RA patients at high or very high CV risk were on anti-hypertensive and/or antiaggregant treatment.ConclusionStatin therapy prescription is suboptimal in RA despite a relevant proportion of patients meeting indications according to LDL thresholds and/or SCORE algorithm. Preventive CV strategies seem mainly focused on anti-hypertensive or antiplatelet therapy. Rheumatologists should pay close attention to lipid levels and preventive therapeutic interventions to reduce the CV risk of RA patients.