Estimation of 10-year Cardiovascular (CV) Risk and Traditional CV Risk Factors Distribution in Patients with Rheumatoid Arthritis from Three Italian Macro-areas

Fabiola Atzeni¹, Fabio Cacciapaglia², Elena Bartoloni Bocci³, Matteo Piga⁴, Garifallia Sakellariou⁵, Ombretta Viapiana⁶, Alessandro Giollo⁷, SIMONE PARISI⁸, Maria Sole Chimenti⁹, Ennio Giulio Favalli¹⁰, Addolorata Corrado¹¹, Eleonora Celletti¹², Ivan Giovannini¹³, Serena Guiducci¹⁴, Elisa Gremese¹⁵, Andreina Manfredi¹⁶, Francesca Romana Spinelli¹⁷ and Gian Luca Erre¹⁸, and "Cardiovascular Obesity and Rheumatic DISeaases" Study Group of the Italian Society of Rheumatology, ¹University of Messina, Italy, Messina, Italy, ²Rheumatology Unit DiMePRe-J, University and AOU Policlinico of Bari, Italy, Bari, Italy, ³Rheumatology Unit. Department of Medicine, Perugia, Perugia, Italy, ⁴Rheumatology Unit - Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy, ⁵Department of Internal Medicine and Medical Therapy, University of Pavia, and Istituti Clinici Scientifici Maugeri IRCCS Pavia,, Pavia, Italy, ⁶Rheumatology Unit, University of Verona, Verona, Italy, ⁷Azienda Ospedale Università Padova, Padova, Padua, Italy, ⁸Rheumatology Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, TURIN, Italy, ⁹Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Roma, Italy, ¹⁰ASST Gaetano Pini-CTO, Milan, Lombardia, Italy, ¹¹Rheumatology Unit, University of Foggia, Foggia, Italy, ¹²Medical Clinic, SS. Annunziata Hospital of Chieti, Department of Medicine and Science of Aging, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy, ¹³Azienda Sanitaria Universitaria Friuli Centrale, Udine, Udine, Italy, ¹⁴University of Florence, Pistoia, Italy, ¹⁵Catholic University of the Sacred Heart, Rome, Rome, Italy, ¹⁶University of Modena and Reggio Emilia, Modena, ¹⁷Sapienza University of Rome, Rome - Italy, Roma, Rome, Italy, ¹⁸Rheumatology Unit - University of Sassari, Sassari, Italy

Meeting: ACR Convergence 2024

Keywords: Access to care, Cardiovascular, Quality Indicators, rheumatoid arthritis, socioeconomic factors

Session Information

Date: Saturday, November 16, 2024

Title: Epidemiology & Public Health Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Geographic origins can significantly impact people’s health, particularly in Italy, where regional health disparities are among the most pronounced [1]. Rheumatoid arthritis (RA) is characterized by increased cardiovascular (CV) disease comorbidity. Traditional CV risk factors in RA patients are more closely related to surrogate CV disease markers than inflammatory indices [2]. This study aimed to compare the prevalence of CV risk factors and the cardiovascular risk score values among groups of RA patients from different macro-areas in Italy.

Methods: This study is a cross-sectional analysis of a longitudinal cohort of 1,421 adult RA patients (357 from the North, 228 from the Center, and 836 from the South of Italy). Several types of information were collected, including demographics, clinical assessments, smoking habits, Body Mass Index (BMI), total cholesterol levels, arterial hypertension, dyslipidemia, use of antihypertensive drugs and statins, obesity (BMI ≥30), and diabetes. The ‘Progetto Cuore’ (PGC), ERS-RA, and Framingham risk scores were also evaluated.

Results: RA patients in the North of Italy are older and have a prolonged disease duration but have lower disease activity (DAS28) and higher remission rates (Table I). Overall, the most prevalent CV risks were dyslipidemia (65.7%) and hypertension (49.7%). When comparing RA patients among the three macro-areas, hypertension was significantly more prevalent in the South (53.8%, p=0.001), and dyslipidemia was less prevalent in the Center (56.5%, p=0.006). At the same time, statin use was less common in the North (14.1%, p=0.010). Although obesity prevalence did not differ among the three macro-areas, BMI values were significantly lower in the North. Regarding health habits, smokers were significantly more prevalent in the Central regions (39.2%, p< 0.001). The ERS-RA and Framingham risk scores, but not the PGC algorithm, significantly differed across Italian regions (Table II).

Conclusion: This study suggests that geographical differences in Italy may influence the CV risk profile in RA patients. Different genetic backgrounds, lifestyles, and dietary habits may explain the observed differences. Further research is needed to assess how geographic and sociocultural factors contribute to CV risk and to develop targeted strategies to improve CV outcomes.

References.
1. Franzini L, Giannoni M. BMC Public Health. 2010;10:296.
2. Sandoo A, et al. Arthritis Res Ther 2013;15:R203.

Table I

Table II

Disclosures: F. Atzeni: None; F. Cacciapaglia: AbbVie/Abbott, 2, 6, Boehringer-Ingelheim, 2, 6, Eli Lilly, 6, Galapagos, 6, Janssen, 2, 6, Pfizer, 6; E. Bartoloni Bocci: None; M. Piga: None; G. Sakellariou: None; O. Viapiana: None; A. Giollo: AbbVie/Abbott, 6, Boehringer-Ingelheim, 6, Eli Lilly, 6, UCB, 6; S. PARISI: None; M. Chimenti: None; E. Favalli: AbbVie, 12, Consultancy/speaker fees from, Bristol-Myers Squibb(BMS), 12, Consultancy/speaker fees from, Celltrion, 12, Consultancy/speaker fees from, Eli Lilly, 12, Consultancy/speaker fees from, Galapagos, 12, Consultancy/speaker fees from, Janssen, 12, Consultancy/speaker fees from, MSD, 12, Consultancy/speaker fees from, Novartis, 12, Consultancy/speaker fees from, Pfizer, 12, Consultancy/speaker fees from, UCB Pharma, 12, Consultancy/speaker fees from; A. Corrado: None; E. Celletti: None; I. Giovannini: None; S. Guiducci: None; E. Gremese: None; A. Manfredi: None; F. Spinelli: Abbvie, 2, 6, Eli Lilly, 6, Galapagos, 2, GlaxoSmithKlein(GSK), 6, Pfizer, 6; G. Erre: None.

To cite this abstract in AMA style:

Atzeni F, Cacciapaglia F, Bartoloni Bocci E, Piga M, Sakellariou G, Viapiana O, Giollo A, PARISI S, Chimenti M, Favalli E, Corrado A, Celletti E, Giovannini I, Guiducci S, Gremese E, Manfredi A, Spinelli F, Erre G. Estimation of 10-year Cardiovascular (CV) Risk and Traditional CV Risk Factors Distribution in Patients with Rheumatoid Arthritis from Three Italian Macro-areas [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/estimation-of-10-year-cardiovascular-cv-risk-and-traditional-cv-risk-factors-distribution-in-patients-with-rheumatoid-arthritis-from-three-italian-macro-areas/. Accessed .

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