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AP Cardiovascular Risk Prediction in Patients with Rheumatic Diseases

Background

Diseases of the rheumatic type are accompanied by an increased risk of the occurrence of arteriosclerosis and an increased cardiovascular mortality rate. Chronic inflammation is an underlying factor in both diseases. The chronic inflammation in rheumatoid diseases may lead to the accelerated development of arteriosclerosis. The role of traditional cardiovascular risk factors in the group of patients with rheumatic diseases and their prognostic value are currently unclear.

Objective

The present project pursues two objectives in particular: First, the prevalence and characteristics of cardiovascular risk factors as well as the (cardiovascular) event rate are to be documented in the follow-up. For this purpose, in accordance with a graduated scheme, 1,000 consecutive patients with inflammatory rheumatic diseases (rheumatoid arthritis, vasculitides, collagenoses, Bechterew‘s disease and psoriatic arthritis) will be examined using non-invasive methods and will be followed for at least five years. Results will be contrasted with patients with osteoarthritis.

Then the prognostic value of established predictor sets (prognosis scores such as EURO-SCORE, PROCAM score, Framingham score) will be compared with a newly derived predictor set in a patient group. The ease of documentation of the predictor as well as the financial resource consumption will be taken into account in the selection of the predictors.

Main result

After a median follow-up of 5.5 years, patients with rheumatoid diseases exhibited a pronounced risk increase for all-cause death: 10-fold unadjusted and 6-fold multivariable-adjusted risk increase comparing patients with rheumatoid disease vs subjects with osteoarthritis. Incident cardiovascular disease and progression/aggravation of cardiac symptoms were also observed more often. Besides the aggravated chronic inflammation, levels of the biomarker NT-proBNP were indicative of worse outcome.

Publications

  • Kung M et al. Cardiovascular comorbidity in rheumatic disease. Does sex play a role? Herz 2005;6:512-21.
  • Störk S. Kardiovaskuläre Erkrankungen bei rheumatoider Arthritis. In: Tony HP (Hg): Langzeittherapie der rheumatoiden Arthritis. Uni-Med, Bremen 2010.

Perspective

The data base has been closed recently. Besides the above mentioned hard clinical endpoints, the current analyses also focus on modifying effects of aspects like quality of life and fatigue on outcome. The database and biobank are open for collaborative research projects with academic and industrial partners. 

Contact

Prof. Dr. Stefan Störk
Universitätsklinikum Würzburg und Deutsches Zentrum für Herzinsuffizienz Würzburg
Phone: +49 (0)931 20146362
E-Mail: ed.grubzreuw-inu.kinilknull@s_kreots