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Volume 33, Issue 2, June 2022



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Mediterr J Rheumatol 2022;33(2):201-17
A Clinical Audit of Cardiovascular Risk Factors and Disease in Patients with Rheumatoid Arthritis - SURF-RA
Authors Information

1Preventive Cardio-Rheuma Clinic, Centre for treatment of Rheumatic and Musculoskeletal Diseases [REMEDY], Diakonhjemmet Hospital, Oslo, Norway

2Centre for treatment of Rheumatic and Musculoskeletal Diseases [REMEDY], Diakonhjemmet Hospital, Oslo, Norway

3Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, United States of America

4IQ Healthcare, Radboud University Nijmegen, Nijmegen, The Netherlands

5Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley, United Kingdom

6Cardiology, Trinity College Dublin, Dublin, Ireland



Abstract
Background and aims: Rheumatoid arthritis (RA) patients are at a high risk of atherosclerotic cardiovascular disease (ASCVD). This implies a need for meticulous CVD risk factor recording and control. Objectives: The aim was to evaluate the international prevalence of ASCVD in RA patients and to audit the prevalence and control of CVD risk factors. Methods: A SUrvey of cardiovascular disease Risk Factors in patients with Rheumatoid Arthritis (SURF-RA) was performed at 53 centres in 19 countries in three continents between 2014 and 2019. CVD risk factors, medication, and physical and laboratory measurements were recorded.  CVD risk was estimated using the ESC’s SCORE system. Results: Among 14503 RA patients in Western (n=8493) and Central and Eastern (n=923) Europe, Mexico (n=407), North America (n=4030) and Asia (n=650) (mean age 59.9 years, 74.5% female), ASCVD was present in 15%, varying from 2.5% in Mexico to 21% in Central and Eastern Europe.  Sixty-two percent reported hypertension and 63% had a LDL-c of > 2.5 mmol/L. Mean BMI was 27.4 kg/m2 in the total cohort, highest in North America (29.7 kg/m2), and lowest in Asia (23.8 kg/m2). A sixth of patients were current smokers, and 13% had diabetes mellitus. Approximately 45% had an estimated high or very high risk of fatal CVD according to SCORE algorithm, and ¾ of patients had only ≤4/6 CVD risk factors at recommended target. Conclusion: Among RA patients across three continents, established CVD and CVD risk factors are common, although geographical variation exists. Furthermore, CVD risk factors often remain inadequately controlled.

Cite this article as: Semb AG, Ikdahl E, Kerola AM, Wibetoe G, Sexton J, Crowson CS, van Riel P, Kitas GD, Graham I, Rollefstad S, SURF-RA collaborators. Mediterr J Rheumatol 2022;33(2):201-17.

Article Submitted: 22 Jan 2022; Revised Form: 23 Mar 2022; Article Accepted: 05 Apr 2022; Available Online: 30 Jun 2022

https://doi.org/10.31138/mjr.33.2.201

This work is licensed under a Creative Commons Attribution 4.0 International License (CC-BY).

©Semb AG, Ikdahl E, Kerola AM, Wibetoe G, Sexton J, Crowson CS, van Riel P, Kitas GD, Graham I, Rollefstad S, SURF-RA collaborators.