ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0292

Comparison of Cardiovascular Risk of Myositis Patients and the General Population

Sabina Oreska1, Hana Storkanova1, Jaroslav Kudlicka2, Vladimir Tuka2, Ondrej Mikes2, Zdislava Krupickova2, Martin Satny2, Eva Chytilova2, Jan Kvasnicka2, Maja Spiritovic3, Barbora Hermankova4, Petr Cesak5, Marian Rybar6, Karel Pavelka1, Ladislav Senolt7, Herman Mann8, Jiri Vencovsky1, Michal Vrablik2 and Michal Tomcik1, 1Institute of Rheumatology, Prague, Czech Republic, Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, 23rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic, 3Institute of Rheumatology, Prague, Czech Republic, Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic, 4Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic, 5Department of Human Movement Laboratory, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic, 6Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic, 7Institute of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Praha, Czech Republic, 8Institute of Rheumatology, Praha 2, Czech Republic

Meeting: ACR Convergence 2023

Keywords: , , ,

Session Information

Date: Sunday, November 12, 2023

Title: (0283–0307) Muscle Biology, Myositis & Myopathies – Basic & Clinical Science Poster I

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Cardiovascular (CV) risk due to accelerated atherosclerosis and impaired metabolism can be increased in idiopathic inflammatory myopathies (IIM) on behalf of systemic inflammation, limited mobility, and glucocorticoid (GC) therapy. We evaluated CV risk in IIM patients in comparison to healthy controls (HC) and assessed its association with disease-specific features.

Methods: 90 IIM (70 females; mean age 56.6; mean disease duration 5.95 years; dermatomyositis: n=29, polymyositis: n=12, immune-mediated necrotizing myopathy (IMNM): n=20, anti-synthetase syndrome: n=29) and 180 HC (130 females, mean age 54.3) with no history of manifested CV disease (both cohorts). Muscle involvement, disease activity, and tissue damage were evaluated (MMT-8, MITAX, MDI). Comorbidities and current treatment were recorded. All subjects underwent examinations of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), ankle-brachial index (ABI), and body composition (densitometry, bioelectrical impedance analysis), evaluation of the risk of fatal CV events by the Systematic COronary Risk Evaluation (SCORE, for the European population) and its modifications: SCORE multiplied by the coefficient 1.5 (mSCORE), and SCORE2.

Results: Compared to HC, IIM had a significantly higher prevalence of traditional CV risk factors, carotid artery disease (CARD), abnormal ABI, and PWV (p< 0.05 for all). After propensity score matching (PSM) using traditional CV risk factors, the prevalence of CARD and pathologic PWV remained significantly higher in IIM (p< 0.05 for all), but no significant difference in SCORE was observed. Overall CV risk based on calculated risk (modifications of SCORE) and ultrasound (US) examinations was comparable between IIM ad HC after PSM (CVR-SCORE p=0.457, CVR-SCORE2 p=0.130, CVR-US p=0.126). IMNM patients had the most unfavorable CV risk profile among IIM subtypes. The calculated CV risk scores by SCORE and SCORE2 (in IIM and HC), and mSCORE (in IIM) were reclassified according to CIMT and CARD. SCORE was the most inaccurate in predicting CV risk in IIM, while there was a significantly higher proportion of reclassified patients compared to SCORE2 and mSCORE (p=0.020). Age, disease activity, lipid profile, body composition parameters, and blood pressure were the most significant predictors of CV risk in IIM (p< 0.05 for all variables in bivariate analysis). The length of GC therapy was positively associated with an increased count of carotid plaques and overall CV risk (by US examination) (p< 0.05 for both).

Conclusion: This cross-sectional cohort study in IIM patients demonstrated a significantly increased risk of subclinical atherosclerosis and CV risk, and also an increased prevalence of traditional CV risk factors compared to HC with comparable age and gender distribution. The most unfavorable findings were seen in IMNM patients. SCORE2 appeared to be the most accurate tool for prediction of fatal CV events in IIM compared to SCORE and mSCORE, although it also underestimates CV risk.

Supported by MHCR (023728; NV18-01-00161A; NU21-01-00146), SVV 260523; BBMRI.cz-LM2023033

Disclosures: S. Oreska: None; H. Storkanova: None; J. Kudlicka: None; V. Tuka: None; O. Mikes: None; Z. Krupickova: None; M. Satny: None; E. Chytilova: None; J. Kvasnicka: None; M. Spiritovic: None; B. Hermankova: None; P. Cesak: None; M. Rybar: None; K. Pavelka: None; L. Senolt: None; H. Mann: None; J. Vencovsky: Argenx, 2, Eli Lilly, 6, Galapagos, 2, Horizon, 2, Merck, 2; M. Vrablik: None; M. Tomcik: None.

To cite this abstract in AMA style:

Oreska S, Storkanova H, Kudlicka J, Tuka V, Mikes O, Krupickova Z, Satny M, Chytilova E, Kvasnicka J, Spiritovic M, Hermankova B, Cesak P, Rybar M, Pavelka K, Senolt L, Mann H, Vencovsky J, Vrablik M, Tomcik M. Comparison of Cardiovascular Risk of Myositis Patients and the General Population [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/comparison-of-cardiovascular-risk-of-myositis-patients-and-the-general-population/. Accessed .

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