Background/Purpose: The European League Against Rheumatism (EULAR) recommends cardiovascular risk (CV) assessment using the systematic coronary risk evaluation (SCORE) chart in rheumatoid arthritis (RA) patients. However, the absolute 10 years CV risk is a statistical and epidemiological concept that could be difficult to understand by our patients, resulting in a lack of adherence to treatment.  The Framinghan heart study (FHS) incorporated the concept of vascular age, as the age of the arteries, a concept more easily understood by all patients. Recently, a calibrated vascular age chart (VAC) according to the SCORE scales was published for european people. 

Objectives: To assess vascular age (VA) in RA patients without CV risk factors/ previous ischemic events using the VAC comparing it with healthy controls. To assess the correlation of several clinical and serological variables with VA. 

Methods: We included 101 consecutive RA patients, according to the 1987 ACR classification criteria, without CV risk factors neither previous ischemic events and matched to 98 healthy controls according to sex, age and gender. We recorded demographic data, clinical and laboratory parameters of disease activity like ESR, CRP, tender and swollen joint counts, DAS28, patient global assessment by visual analogue scale, lipid profile and RA characteristics. We assessed VA  using the VAC.  Data was analyzed with the statistical software SPSS 15. Descriptive data were shown as percentages and mean±SD. To analyze data, we use simple lineal regression test with correlation and the multiple lineal regression analysis. The limit of statistical significance was located in the α error of 0,05.

Results: In RA patients, the median chronologic age (CA) was 53,83±8,28 years, VA was 56,67±9,84  and absolute CV risk was 1,43±1,1. Of these patients, 20% fulfilled EULAR criteria for higher CV risk (20% had more than 10 years of disease, 9% had extra articular manifestations, 77% were positive RF and 48% had ACPA). In controls, CA was 53,52±8,37, VA was 55,78±9,82 and absolute CV risk was 1,1±1. After applying lineal regression test, VA was correlated with CA (beta 1.096, p=0.000); however, there were not differences in VA between both groups (beta -0.62, p=0,232). Of interest, after adjusting for confounding factors, VA seem to be correlated with presence anti-citrullinated peptide antibodies (ACPA) p<0,021. 

Conclusion: In our study we did not find differences between VA in RA patients without CV risk factors in comparison to healthy controls, but we found a well correlation between VA and the CA. Presence of ACPA seems to predict higher vascular age.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/vascular-age-in-rheumatoid-arthritis-patients/