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Rheumatoid Arthritis, Statin Indication and Lipid Goals: Analysis According to Different Recommendations

Walter Masson1, Emiliano Rossi1, Rodolfo N Alvarado2

  • 1Servicio de Cardiología, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB Ciudad Autónoma de Buenos Aires, Argentina.

Reumatologia Clinica
|March 22, 2021
PubMed

Insights

Cardiovascular risk in rheumatoid arthritis (RA) patients varies by strategy, with significant gaps in statin therapy and LDL-C goal achievement. Different guidelines yield different statin indications for RA patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Public Health

Background:

  • Cardiovascular disease (CVD) is a major concern for patients with rheumatoid arthritis (RA).
  • Effective cardiovascular risk management strategies are crucial for RA patients.
  • Current guidelines offer various approaches to managing cardiovascular risk in RA.

Purpose of the Study:

  • To compare different cardiovascular risk assessment strategies in RA patients.
  • To determine the proportion of RA patients eligible for statin therapy under various guidelines.
  • To evaluate the achievement of lipid goals in RA patients based on European recommendations.

Main Methods:

  • A cross-sectional study utilizing a secondary database.
  • Estimation of cardiovascular risk using QRISK-3, Framingham, ASCVD, and SCORE calculators.
  • Analysis of statin therapy indications based on NICE, Argentine Consensus, ACC/AHA, and European guidelines.

Main Results:

  • Different guidelines resulted in varying eligibility for statin therapy (18.2%–41.1%).
  • Only 24.7% (primary) and 48.7% (secondary) prevention patients were on statins.
  • Under European guidelines, 50.0%, 46.2%, and 15.9% of low-moderate, high, and very high-risk patients met lipid goals, respectively.

Conclusions:

  • Cardiovascular risk stratification and statin indication differ significantly across the four analyzed strategies in RA patients.
  • A notable discrepancy exists between recommended and actual statin use.
  • Few RA patients achieve their target LDL-C goals, highlighting a need for improved lipid management.
Abstract

Keywords:
Artritis reumatoideEstatinasEstratificación de riesgoLDL-C goalsObjetivos de C-LDLPuntuaciones de riesgoRheumatoid arthritisRisk scoresRisk stratificationStatins

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