Statin indication according to the 2019 World Health Organization cardiovascular disease risk charts and carotid ultrasound in Mexican mestizo rheumatoid arthritis patients.
Adv Rheumatol
; 62(1): 4, 2022 01 25.
Article
em En
| MEDLINE
| ID: mdl-35078534
BACKGROUND: We aimed to assess the concordance of recommendation for initiating statin therapy according to the 2019 World Health Organization (WHO) cardiovascular disease (CVD) risk charts and to the presence of carotid plaque (CP) identified with carotid ultrasound in Mexican mestizo rheumatoid arthritis (RA) patients, and to determine the proportion of patients reclassified to a high cardiovascular risk after the carotid ultrasound was performed. METHODS: This was a cross-sectional study nested of a RA patients' cohort. A total of 157 Mexican mestizo RA patients were included. The cardiovascular evaluation was performed using the 2019 WHO CVD risk charts (laboratory-based model) for the Central Latin America region. A carotid ultrasound was performed in all patients. The indication to start statin therapy was considered if the patient was classified as high risk, moderate risk if > 40 years with total cholesterol (TC) > 200 mg/dl or LDL-C > 120 mg/dl, and low risk if > 40 years with TC > 300 mg/dl, according to the WHO CVD risk chart or if the patient had carotid plaque (CP). Cohen's kappa (k) coefficient was used to evaluate the concordance between statin therapy initiation. RESULTS: Initiation of statin therapy was considered in 49 (31.2%) patients according to the 2019 WHO CVD risk charts and 49 (31.2%) patients by the presence of CP. Cardiovascular risk reclassification by the presence of CP was observed in 29 (18.9%) patients. A slight agreement (k = 0.140) was observed when comparing statin therapy recommendations between 2019 WHO CVD risk charts and the presence of CP. CONCLUSION: The WHO CVD risk charts failed to identify a large proportion of patients with subclinical atherosclerosis detected by the carotid ultrasound and the concordance between both methods was poor. Therefore, carotid ultrasound should be considered in the cardiovascular evaluation of RA patients.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Doenças Cardiovasculares
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Inibidores de Hidroximetilglutaril-CoA Redutases
Tipo de estudo:
Etiology_studies
/
Guideline
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Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Mexico
Idioma:
En
Revista:
Adv Rheumatol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
Reino Unido