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1. Incidence of first cardiovascular event in Spanish patients with inflammatory rheumatic diseases: prospective data from the CARMA Project

Author

Martin-Martinez M, Castaneda S, Gonzalez-Juanatey C, Sanchez-Alonso F, Garcia-Gomez C, Lopez-Gonzalez R, Babio-Herraiz J, Juan-Mas A, Moreno-Gil M, Sanchez-Gonzalez C, Romera-Baures M, Pinto-Tasende J, Tornero-Molina J, Fabregas-Canales D, Llorca J, Gonzalez-Gay M, de Rabago E, Morales E, Lopez J, Villar N, Sandoval A, Garcia F, De Miquel C, Fernandez M, Codina R, Yoldi B, Ramentol M, Avila G, Barril S, Quesada E, Steiner M, Munoz S, Cobo T, Gamero F, Toron J, Espino P, Ros I, Ibanez M, Murillo C, Sanmarti R, Berman H, Cabrera S, Ruiz V, Paton O, Gutierrez B, Abasolo L, Pina J, Nolla J, Arias M, Vadillo J, de Vicuna R, Nebro A, Arija S, Lopez M, Urena I, Irigoyen M, Cagigal V, Garrido D, Aparicio A, Gomez R, Bautista P, Sanz A, Bachiller J, Manero F, Zorzo F, Ubeda E, Garcia J, Audera C, Medrano M, Pecondon A, Erausquin C, Ojeda S, Quevedo J, Francisco F, Lozano C, Longo F, Gerona D, Fernandez C, Monteagudo I, del Pino J, Gonzalez M, Corrales A, Peiro M, Senabre J, Rosas J, Rotes I, Moreno E, Erra A, Grado D, Calvo J, Rueda A, Moller I, Rodriguez I, Barbadillo C, Raya E, Morales P, Nieto A, Jimenez I, Magro C, Escribano A, Exposito S, Nievas G, Navarro E, Morales M, Bastero I, Consuegra G, Palmou N, Pardo S, Pujol M, Alonso E, Salvador G, Alvarez B, Cantabrana A, Bustabad S, Delgado E, Munoz A, Montero S, Jimenez L, Redondo J, Hernandez T, Polo F, Almagro R, Moreno J, Serret E, Barroso C, Mendez L, Navio M, Carballido C, Pagan E, del Castillo P, Naredo E, Cruz A, Turrion A, Sanchez J, Galindo M, Gonzalez J, Collantes E, Ruiz D, Font P, Bonilla G, Meseguer A, Moreno M, Martinez M, Linares L, Morcillo M, Gomez M, Rivera N, Berrizbeitia O, Vivar M, Riera M, Leon Y, Maymo J, Amirall M, Escolano S, Serrano S, Bona M, Fiter J, Melon J, Espadaler L, Maiz O, Belzunegui J, Banegil I, Diaz C, Valls R, Castellvi I, Bonet M, Ruzafa E, Alen J, Sandoval T, Evrard E, Godo J, Espartero C, Blasco F, Miranda-Filloy J, and CARMA Project Collaborative Grp

Subjects
rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, incidence, cohort study, CARMA project, cardiovascular diseases
Abstract

Objective To determine the incidence and risk factors of first cardiovascular event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD). Methods Analysis of data after 2.5 years of follow-up from the prospective study CARMA project, that includes patients with CIRD [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)] and matched individuals without CIRD from 67 hospitals in Spain. CVE cumulative incidence per 1000 patients was calculated after 2.5 years from the start of the project. Weibull proportional hazard model was used to calculate hazard ratio (HR) and 95% confidence interval (95% CI) of the risk factors. Results 2595 (89.1%) patients completed the 2.5 years of follow-up visit. Cumulative incidence of CVE in patients with CIRD was 15.30 cases per 1000 patients (95% CI: 12.93-17.67), being higher in the subgroup with AS; 22.03 (95% CI: 11.01-33.04). Patients with AS (HR: 4.11; 95% CI: 1.07-15.79), those with older age (HR: 1.09; 95% CI: 1.05-1.13), systolic hypertension (HR: 1.02; 95% CI: 1.00-1.04) and long duration of the disease (HR: 1.07; 95% CI: 1.03-1.12) were at higher risk of first CVE during the 2.5 years of follow-up. In contrast, female gender was a protective factor (HR: 0.43; 95% CI: 0.18-1.00). Conclusion Among CIRD patients prospectively followed-up at rheumatology outpatient clinics, those with AS show higher risk of first CVE. Besides cardiovascular risk factors, such as hypertension, being a man and older

Published
2019

2. Hyperlipoproteinaemia(a) in patients with spondyloarthritis: results of the Cardiovascular in Rheumatology (CARMA) project

Author

Garcia-Gomez, C, Martin-Martinez, M, Fernandez C, Castaneda, S, Gonzalez-Juanatey, C, Sanchez-Alonso, F, Gonzalez-Fernandez, M, Sanmarti, R, Garcia-Vadillo, J, Fernandez-Gutierrez, B, Garcia-Arias, M, Manero, F, Senabre, J, Rueda-Cid, A, Ros-Exposito, S, Pina-Salvador, J, Erra-Duran, A, Moller-Parera, I, Llorca, J, Gonzalez-Gay, M, Gonzalez de Rabago, E, Blanco Morales, E, Fernandez Lopez, J, Oreiro Villar, N, Atanes Sandoval, A, Blanco Garcia, F, Alegre De Miquel, C, Gonzalez Fernandez, M, Huguet Codina, R, Yoldi, B, Ramentol, M, Avila, G, Marsal Barril, S, Steiner, M, Munoz, S, Gamero, F, Garcia Toron, J, Moreno Gil, M, Mas, A, Espino, P, Ros, I, Ibanez, M, Murillo, C, Piqueras, J, Berman, H, Cabrera, S, Ruiz, V, Fontsere Paton, O, Fernandez Gutierrez, B, Abasolo, L, Fabregas, M, Romera Baures, M, Nolla, J, Gonzalez-Alvaro, I, Tomero Muriel, E, Garcia de Vicuna, R, Fernandez Nebro, A, Belmonte Lopez, M, Urena, I, Irigoyen, M, Coret Cagigal, V, Lopez Gonzalez, R, Pielfort Garrido, D, Sampedro Alvarez, J, Garcia Aparicio, A, Belmonte Gomez, R, Granados Bautista, P, Hernandez Sanz, A, Sanchez Gonzalez, C, Bachiller, J, Zea, A, Jimenez Zorzo, F, Gimenez Ubeda, E, Marzo Gracia, J, Beltran Audera, C, Medrano, M, Pecondon, A, Erausquin, C, Ojeda, S, Carlos Quevedo, J, Francisco, F, Rodriguez Lozano, C, Babio Herraez, J, Lopez Longo, F, Gerona, D, Gonzalez Fernandez, C, Carreno, L, Monteagudo, I, del Pino, J, Sanchez Gonzalez, M, Corrales, A, Enriqueta Peiro, M, Rosas, J, Rotes, I, Moreno, E, Erra, A, Grado, D, Calvo, J, Rueda, A, Moller, I, Rodriguez, I, Barbadillo, C, Raya, E, Morales, P, Nieto, A, Jimenez, I, Magro, C, Ruibal Escribano, A, Ros Exposito, S, Sanchez Nievas, G, Judez Navarro, E, Sianes Fernandez, M, Garcia Morales, M, Labiano Bastero, I, Consuegra, G, Palmou, N, Martinez Pardo, S, Pujol, M, Riera Alonso, E, Salvador, G, Gonzalez Alvarez, B, Cantabrana, A, Bustabad, S, Delgado, E, Munoz, A, Rodriguez Montero, S, Maria Jimenez, L, Rivera Redondo, J, Gonzalez Hernandez, T, Gonzalez Polo, F, Menor Almagro, R, Moreno, J, Giner Serret, E, Lannuzzelli Barroso, C, Cebrian Mendez, L, Teresa Navio, M, Fernandez Carballido, C, Pagan, E, Mesa del Castillo, P, Naredo, E, Cruz, A, Turrion, A, Mateo, I, Sanchez, J, Galindo, M, Garcia Gonzalez, J, Collantes, E, Ruiz, D, Font, P, Bonilla, G, Lopez Meseguer, A, Moreno, M, Moreno Martinez, M, Beteta Fernandez, M, Linares, L, Morcillo, M, Gonzalez Gomez, M, Aramburu, J, Rivera, N, Fernandez Berrizbeitia, O, Garcia Vivar, M, Riera, M, Maria Leon, Y, Maymo, J, Amirall, M, Iniesta Escolano, S, Sanchez Serrano, S, Lis Bona, M, Fiter, J, Fernandez Melon, J, Espadaler, L, Maiz, O, Belzunegui, J, Banegil, I, Diaz, C, Valls, R, Castellvi, I, Bonet, M, Moreno Ruzafa, E, Calvo Alen, J, Perez Sandoval, T, Revuelta Evrard, E, Godo, J, Fernandez Espartero, C, Navarro Blasco, F, Antonio Gonzalez, J, Miranda-Filloy, J, and CARMA Project Collaborative Grp

Subjects
musculoskeletal diseases, psoriatic arthritis, lipids, stomatognathic diseases, cardiovascular disease, lipoprotein(a), ankylosing spondylitis, spondyloarthritis
Abstract

Objective Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. Methods A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia( a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. Results 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95% CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95% CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. Conclusion SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.

Published
2019

3. Influence of demographic and clinical factors on the mortality rate of a rheumatoid arthritis cohort: A 20-year survival study

Author

Abasolo, L, Ivorra-Cortes, J, Leon, L, Jover, JA, Fernandez-Gutierrez, B, and Rodriguez-Rodriguez, L

Subjects
Radiographic joint damage, Rheumatoid arthritis, Mortality, Survival analysis
Abstract

Objectives: To describe the mortality rate (MR) and standardized MR (SMR) of an incident cohort of rheumatoid arthritis (RA) patients followed up for 20 years, and to analyze the influence on morality risk of different demographic and clinical variables, including radiographic joint damage. Methods: Retrospective longitudinal study that included 2271 RA patients attending the rheumatology outpatient clinic of the Hospital Clinico San Carlos (Madrid, Spain), enrolled from January 1994 to February 2013 and followed up from RA diagnosis to patients' death or September 2013. Disability and disease activity were measured as the averaged value of the Heath Assessment Questionnaire and the erythrocyte sedimentation rate, respectively, of the first 2 years after RA diagnosis. Radiographic joint damage of hands and wrists was assessed with the Sharp/van der Heijde score. Indirect SMRs with a 95% of confidence interval (95% CI) were calculated. Cox bivariate and multivariate regression models were performed to assess risk factors for death. Results: A total of 431 patients died (19%) during the observation time (18,482 person-years), resulting in a MR of 23 subjects per 1000 patient-years [95% CI: 21-261. SMR was 1.89 (1.72-2.08). In the multivariate analysis, men, older age at diagnosis, the presence of rheumatoid factor, higher number of hospital admissions, greater disease activity, and greater radiographic joint damage were independently associated with greater mortality risk. Conclusions: RA patients have an excess mortality compared with the general population. Radiological joint damage and early disease activity are independent mortality risk factors. A tighter control at early stages may be necessary to reduce mortality. (C) 2016 Elsevier Inc. All rights reserved.

Published
2016

4. Patterns of disease modifing antirheumatic drug use in a Spanish cohort of patients with rheumatoid arthritis

Author

Gonzalez-Alvaro, I., Loreto Carmona, Balsa, A., Sanmarti, R., Belmonte, M. A., Tena, X., Tenorio, M., Roselló, R., Ramos, P., Rivera, J., Rodríguez Gómez, M., Jiménez Palop, M., Hernández Del Río, A., Villaverde, V., Irigoyen, M. V., Peiró, E., Juan, A., Larrosa, M., Manero, F. J., Mayordomo, L., Mazzucheli, R., Pecondón, A., Corteguera, M., Cuadra, J. L., Galindo, M., Aragón, A., Batlle, E., Abasolo, L., Gómez Centeno, E., Valdazo Diego, J. P., González Hernández, T., Gómez Vaquero, C., Casado, E., Alegre, C., García Meijide, J. A., González Fernández, M. J., González Gómez, M. L., Andreu, J. L., Audera, B., Beltrán Fabregat, J., Mateo, I., Grandal, Y., Gratacos, J., Instxaurbe, A. R., Giménez Ubeda, E., Medrano, M., Naranjo, A., Quirós, J., Rodríguez López, M., Sampedro, J., Santos, J., Ureña, I., Zarco, P., and Zubieta, J.

5. Association of apolipoprotein B/apolipoprotein A1 ratio and cardiovascular events in rheumatoid arthritis: Results of the CARMA study

Author

Zegarra-Mondragón, S., López-González, R., Martín-Martínez, M. A., García-Gómez, C., Sánchez-Alonso, F., González-Juanatey, C., Arija, S. M., Hernán, G. B., Pardo, S. M., Escribano, A. R., García, E. P., Frías, E. D., Redondo, J. R., Sánchez, M. D., Cambrón, A. B. R., Ramos, M. J. M., Montero, S. A. R., Marco, M. T. N., Valle, M. M., Gonzalez, J. G., Corral, J. B., Llorca, J., Castañeda, S., González-Gay, M. A., Rabago, E. G., Morales, E. A. B., Carlos Fernández Lopez, J., Villar, N. O., Sandoval, A. A., Blanco García, F. J., Miquel, C. A., González Fernández, M. J., Codina, R. H., Yoldi, B., Ramentol, M., Ávila, G., Barril, S. M., Quesada, E., Steiner, M., Muñoz, S., Cobo, T., Gamero, F., Torón, J. G., Espino, P., Ros, I., Ibáñez, M., Murillo, C., Molina, J. T., Raimon Sanmarti, Berman, H., Cabrera, S., Ruiz, V., Patón, O. F., Gutierrez, B. F., Abasolo, L., Pina, J. M., Canals, D. F., Nolla, J. M., Arias, M. G., Uriarte, M., García Vadillo, J. A., Vicuña, R. G., Nebro, A. F., López, M. A. B., Ureña, I., Irigoyen, M. V., Cagigal, V. C., Garrido, D. P., García Aparicio, A. M., Gómez, R. B., Bautista, P. G., Sanz, A. H., Manero, F. J., Zorzo, F. J., Ubeda, E. G., Gracía, J. M., Audera, C. B., Medrano, M., Pecondón, Á, Erausquin, C., Ojeda, S., Quevedo, J. C., Francisco, F., Lozano, C. R., López Longo, F. J., Gerona, D., Fernández, C. G., Monteagudo, I., Del Pino, J., González, M. D. S., Corrales, A., Peiró, M. E., Senabre, J. M., Rosas, J. C., Rotés, I., Moreno, E., Erra, A., Grado, D., Calvo, J., Rueda, A., Möller, I., Rodríguez, I., Barbadillo, C., Raya, E., Morales, P., Nieto, A., Jiménez, I., Magro, C., Expósito, S. R., Nievas, G. S., Navarro, E. J., Fernández, M. S., García Morales, M. A., Bastero, I. L., Consuegra, G. G., Palmou, N., Pujol, M., Alonso, E. R., Salvador, G., Alvarez, B. G., Cantabrana, A., Bustabad, S., Muñoz, A., Jimenez, L. M., Hernandez, T. G., González Polo, F. J., Almagro, R. M., Moreno, J. M., Serret, E. G., Barroso, C. L., Méndez, L. C., Carballido, C. F., Del Castillo, P. M., Naredo, E., Valenciano, A. C., Villa, C. M., Turrión, A., Sánchez, J., Galindo, M., Collantes, E., Ruiz, D., Font, P., Bonilla, G., Meseguer, A. L., Moreno Martínez, M. J., Beteta Fernández, M. D., Linares, L. F., González Gómez, M. L., Rivera, N. A., Berrizbeitia, O. F., García Vivar, M. L., Riera, M., León, Y. M., Maymó, J., Amirall, M., Escolano, S. I., Serrano, S. S., Lis Bona, M. P., Fiter, J., Melón, J. F., Espadaler, L., Maiz, O., Belzunegui, J., Díaz, C., Valls, R., Castellví, I., Bonet, M., Ruzafa, E. M., Alen, J. C., Sandoval, T. P., Evrard, E. R., Godo, J. R., Espartero, C. F., Navarro Blasco, F. J., Antonio González, J., and Miranda-Filloy, J. A.

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