ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1247

Delay in Diagnosis of Rheumatoid Arthritis Increases the Cardiovascular Risk

Chan-Bum Choi1, Yoon-Kyoung Sung2, Soo-Kyung Cho2, Dae-Hyun Yoo3, Shin-Seok Lee4, Jisoo Lee5, Jinseok Kim6, Hye-Soon Lee7, Tae-Hwan Kim3, Bo Young Yoon8, Wan-Hee Yoo9, Jung-Yoon Choe10, Sang-Heon Lee11, Seung-Cheol Shim12, Won-Tae Chung13, Seung-Jae Hong14, Choong Ki Lee15, Eunmi Koh16, Jae-Bum Jun3, So-Young Bang7, Seong-Kyu Kim17, Hoon-Suk Cha16, Jeeseon Shim18, Sang-Cheol Bae19 and Korean Observational Study Network for Arthritis (KORONA)20, 1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 2Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 3Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 4Dept of Int Med/Rheumatology, Chonnam National University Medical School, Gwangju, South Korea, 5Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea, 6Internal Medicine, Jeju National University Hospital, Jeju, South Korea, 7Department of Rheumatology, Hanyang University Guri Hospital, Guri, South Korea, 8Inje University Ilsan Paik Hospital, Goyang, South Korea, 9Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, South Korea, 10Internal Medicine, Catholic university of Daegu School of mediine, Arthritis and autoimmunty research center, Daegu, 11Division of Rheumatology, Department of Internal Medicine,, Konkuk University School of Medicine, Seoul, South Korea, 12Rheumatology, Eulji University Hospital, Daejeon, South Korea, 13Rheumatology, Dong-A University Hospital, Busan, South Korea, 14Division of Rheumatology, Department of Internal Medicine, Kyung Hee University, Seoul, South Korea, 15Internal medicine, school of medicine, Yeungnam University, Daegu, South Korea, 16Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 17Catholic University of Daegu School of Medicine, Daegu, South Korea, 18Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 19Hanyang University Hospital for Rheumatic Disease, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 20Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects II: Clinical Features & Comorbidity/Cardiovascular Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose: Patients with rheumatoid arthritis (RA) are known to be at increased risk for cardiovascular diseases. Inflammation as well as traditional risk factors contributes to this risk and adequate control of the disease activity of RA will decrease it. We investigated whether earlier diagnosis and earlier initiation of treatment would decrease the risk of cardiovascular diseases in patients with RA.

Methods: RA patients from the KORONA (Korean Observational Study Network for Arthritis) prospective multicenter cohort were assessed. Information on RA onset to diagnosis, disease duration, disease activity, functional impairment, smoking status, cardiovascular comorbidities, and cardiovascular risk using SCORE (Systematic Coronary Risk Evaluation) risk chart were obtained from questionnaires and medical records. Regression models were used to assess the association between delay in diagnosis of RA and cardiovascular risk, adjusting for disease duration, disease activity, radiographic damage, functional impairment, body-mass index, and methotrexate, steroids, NSAIDs, and biologics use.

Results: The mean delay from RA onset to diagnosis was 1.8 ± 4.1 years. A total of 2,465 patients were diagnosed within a year from onset with a mean delay of 0.2 ± 0.3 years and diagnosis was delayed more than a year in 1,023 patients with a mean of 5.5 ± 6.1 years. Patients with delayed diagnosis were significantly older at assessment, younger at diagnosis, and had longer disease duration. There was no difference in current disease activity assessed by DAS28, but patients with delayed diagnosis showed significantly higher functional impairment (p < 0.01). Proportion of patients smoking, taking corticosteroids and/or NSAIDs were significantly lower in the delayed diagnosis group (p < 0.01, p = 0.03, p <0.01, respectively). SCORE risk score was significantly higher in patients with delayed diagnosis with 1.3 ± 1.7 compared to 1.1 ± 1.7 in patients with diagnosis within a year (p < 0.01). The association between delay in diagnosis of RA and increase in cardiovascular risk calculated by SCORE risk score remained significant in women after adjustment (p < 0.01), but it was lost in men (p = 0.12).

Conclusion: Delay in diagnosis of rheumatoid arthritis can lead to increase in major cardiovascular risk, especially in women.

Disclosure:

C. B. Choi,
None;

Y. K. Sung,
None;

S. K. Cho,
None;

D. H. Yoo,
None;

S. S. Lee,
None;

J. Lee,
None;

J. Kim,
None;

H. S. Lee,
None;

T. H. Kim,
None;

B. Y. Yoon,
None;

W. H. Yoo,
None;

J. Y. Choe,
None;

S. H. Lee,
None;

S. C. Shim,
None;

W. T. Chung,
None;

S. J. Hong,
None;

C. K. Lee,
None;

E. Koh,
None;

J. B. Jun,
None;

S. Y. Bang,
None;

S. K. Kim,
None;

H. S. Cha,
None;

J. Shim,
None;

S. C. Bae,
None;

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