RMD Open (Jul 2021)
Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: an international audit
- George Athanasios Karpouzas,
- Eirik Ikdahl,
- Silvia Rollefstad,
- Grunde Wibetoe,
- Anne Grete Semb,
- Joseph Sexton,
- Patrick Durez,
- Maria G Tektonidou,
- Michal Tomčík,
- Dionicio Angel Galarza-Delgado,
- Ian Graham,
- Miguel A González-Gay,
- Solbritt Rantapää-Dahlqvist,
- Erkin M Mirrakhimov,
- Petros P Sfikakis,
- Virginia Pascual-Ramos,
- Carol Hitchon,
- Maria Simona Stoenoiu,
- Elena Myasoedova,
- Durga Prasanna Misra,
- Vikas Agarwal,
- Dimitrios Vassilopoulos,
- Piet van Riel,
- Bindee Kuriya,
- George Kitas,
- Rong Mu,
- Anne M Kerola,
- Karen Douglas,
- Andrew A Borg,
- Pompilio Faggiano,
- Cindy Crowson,
- Argyro Lazarini,
- Diane Gheta,
- Svetlana Myasoedova,
- Lev Krougly,
- Tatiana Valentinovna Popkova,
- Alena Tuchyňová,
- Michal Vrablik,
- Pavel Horak,
- Helena Kaspar Medkova
Affiliations
- George Athanasios Karpouzas
- Internal Medicine-Rheumatology, Harbor-UCLA Medical Center, Torrance, California, USA
- Eirik Ikdahl
- Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Silvia Rollefstad
- Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Grunde Wibetoe
- Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Anne Grete Semb
- Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Joseph Sexton
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Patrick Durez
- Rheumatology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Maria G Tektonidou
- First Department of Propaedeutic and Internal Medicine, University of Athens, Athens, Greece
- Michal Tomčík
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
- Dionicio Angel Galarza-Delgado
- Rheumatology, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Nuevo León, Mexico
- Ian Graham
- Cardiology, Trinity College Dublin, Dublin, Ireland
- Miguel A González-Gay
- Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain
- Solbritt Rantapää-Dahlqvist
- Department of Public Health and Clinical Medicine/Rheumatology, Umea University, Umea, Sweden
- Erkin M Mirrakhimov
- Kyrgyz State Medical Academy Faculty of General Medicine, Bishkek, Kyrgyzstan
- Petros P Sfikakis
- First Department of Propaedeutic and Internal Medicine, University of Athens, Athens, Greece
- Virginia Pascual-Ramos
- Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- Carol Hitchon
- Rheumatology, University of Manitoba, Winnipeg, Manitoba, Canada
- Maria Simona Stoenoiu
- Rheumatology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Elena Myasoedova
- Division of Rheumatology, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Durga Prasanna Misra
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
- Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
- Dimitrios Vassilopoulos
- nd Department of Medicine and Laboratory, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
- Piet van Riel
- Rheumatology, Radboud University Nijmegen, Nijmegen, The Netherlands
- Bindee Kuriya
- Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- George Kitas
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley, UK
- Rong Mu
- Rheumatology, Peking University People’s Hospital, Beijing, China
- Anne M Kerola
- Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- Karen Douglas
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley, UK
- Andrew A Borg
- Department of Rheumatology, Mater Dei Hospital, Msida, Malta
- Pompilio Faggiano
- Cardiothoracic, Fondazione Poliambulanza Instituto Ospedaliero, Brescia, Italy
- Cindy Crowson
- Health Sciences Research, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Argyro Lazarini
- nd Department of Medicine and Laboratory, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
- Diane Gheta
- Medicine, Tallaght University Hospital, Dublin, Ireland
- Svetlana Myasoedova
- Rheumatology, Ivanovo State Medical Academy, Ivanovo, Ivanovskaa oblast, Russian Federation
- Lev Krougly
- Rheumatology, FSBI National Medical and Surgical Center named after N I Pirogov of the Ministry of Healthcare of the Russian Federation, Moskva, Russian Federation
- Tatiana Valentinovna Popkova
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
- Alena Tuchyňová
- Rheumatology, Narodny Ustav Reumatickych Chorob, Piestany, Slovakia
- Michal Vrablik
- Third Department of Internal Medicine, Department of Endocrinology and Metabolism, Charles University First Faculty of Medicine, Praha, Czech Republic
- Pavel Horak
- Department of Internal Medicine III–Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Olomoucký, Czech Republic
- Helena Kaspar Medkova
- Division of Rheumatology, 2nd Department of Internal Medicine–Gastroenterology, Charles University First Faculty of Medicine, Hradec Králové, Czech Republic
- DOI
- https://doi.org/10.1136/rmdopen-2021-001724
- Journal volume & issue
-
Vol. 7,
no. 2
Abstract
Aim The 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.Methods The 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.Results The 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.Conclusion CVD 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 .