Cardiovascular risk stratification in autoimmune diseases in a university hospital

Abstract

Introduction: Autoimmune diseases (AID) have been considered as non-fatal; however, most of these have a natural history of premature mortality. Some such as lupus erythematosus (SLE), rheumatoid arthri-tis (RA), systemic sclerosis (SS), polymyositis, vasculitis and others are associated with early mortality comparable to cardiovascular and neo-plastic diseases.Objectives: 1- Identify autoimmune diseases with increased cardiovas-cular risk in previously diagnosed patients who are treated at a rheuma-tology service of an university hospital. 2- To compare the cardiovascu-lar risk calculated according to the Framingham and the SCORE model in patients with a previous diagnosis of autoimmune disease treated at a rheumatology service of a public hospital. Methods: A cross-sectional analytical study in the rheumatology de-partment of an university hospital was carried out where 129 medical records of patients were recruited. They came spontaneously between November 1, 2010 and May 31, 2011. Tables of combination of vari-ables were carried out and its subsequent calculation with the help of the Chi Square statistical coefficient and Pearson coefficient.Results: The AID with increased cardiovascular risk were RA, vascu-litis and EASN. The Framingham showed a single patient with RA who had very high CVR. The high CVR was led by vasculitis with 16.7%, but it must be stressed that this corresponds to a single patient. The second place was represented by RA (10.7%), then EASN (10%) and SLE (4.5%). The SCORE model showed that 3.1% of the diseases had a very high cardiovascular risk, and this percentage was comprised of 3 patients with RA and 1 with vasculitis. The high CVR was represented only by 13.3% RA. When comparing the two scales of cardiovascular risk, 70.5% of 129 patients had low CVR. Only one patient (0.8%) with low cardiovascular risk in the Framingham had very high CVR in SCORE. According to the correlation coefficient R of Pearson association exists a level of almost 50%, therefore, it was shown that there is good cor-respondence between these variables.Conclusion: We found a positive correlation between the two scales, and diseases with increased cardiovascular risk were RA, vasculitis and EASN, highlighting the low number of cases in the last two compared with RA. Notoriously, the evidence level is higher in RA and SLE than in any other autoimmune disease. This does not rule out that the rest of them carry high CVR. Prospective multi-centre studies should consider for the development of guides the rest of autoimmune diseases or for the implementation of existing ones. This work presents no conflict of interest.