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#ACR21 Abst#0285
Calculated 10-yr CV risk ↑ w/in 1st yr of new RA dx in 53 Dutch pts:
➤43% had intermediate (I) or high (H) morbidity risk
➤76% had I or H mortality risk
◘ avg 57yo, 74%♀, 72% HTN, & 57% HLD
*️⃣ Early CV risk assessment critical at RA diagnosis!
@Rheumnow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 Abst#0271
➡️Patients 40-75 yo w/ RA dx in the prior 5 yrs have ⬆️ prevalence of subclinical athero vs age-matched controls.
→ Should we consider obtaining a carotid US at time of RA dx & monitor per risk status to help optimize CV risk? @Rheumnow
https://t.co/3PpHIRk984 https://t.co/ChRTU7zACk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Prolonging the Controversy of Hydroxychloroquine
Dr. Kathryn Dao (@KDAO2011 ) shares several abstracts from #ACR21 that addressed the topic of HCQ and cardiovascular safety.
https://t.co/J6sVzYJkUZ https://t.co/dBZmtwQ927
Links:
Dr. John Cush RheumNow ( View Tweet)
#ACR21 #Abstr0189 Another case for early intervention. Median time-to-Rilonacept (IL1-i) monotherapy for recurrent pericarditis was 7.9 weeks! During this time, >94% pts discontinued steroid and/or colchicine either sequentially or concurrently @RheumNow https://t.co/ofi3Jtm6j6 https://t.co/b6PnFw4gUN
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Active RA w/ large joint swelling & co-existent CVD & diabetes associated with ⬆️risk of #AlzheimersDisease & related #dementia in RA pts.
👉~1300 patients
👉Among CVD conditions, #stroke & #CHF assoc w/ the risk of #dementia
#ACR21 Abs#0284 @RheumNow
https://t.co/N3x2ZtBFGe https://t.co/kFyf3A0gha
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abst#0284
My 56 yo ♀RA pt expressed concern for developing dementia last wk. This study helps recognize her RF beyond aging:
➡️ Large joint swelling (HR 2.2)
➡️ CVD (HR 2.4): stroke (HR 3.2) + chronic HF (HR 1.8)
➡️ DM (HR 1.6)
#ACRBest @Rheumnow
https://t.co/wsZnaLwSmD
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Which pt has more MIs post elective surgery? #ACR21 @RheumNow abst#0128
Janet Pope Janetbirdope ( View Tweet)
#SLE pts have equal rates of post op CV events compared to TypeII DM pts and ⬆️ compared to matched controls. Esp driven by comorbidities. Should we add ASA post op in SLE pts with CV risks? #ACR21 #abst0128 @RheumNow https://t.co/COdbDxFgBQ
Janet Pope Janetbirdope ( View Tweet)
#ACR21 Abst#0293:
Lung involvement in 67 sero+ RA pts assoc w/:
⭐︎ SSc-specific ab
➡️ RP155, Th/To, fibrillarin, NOR90 in ILD group
➡️ Ku, Pm/Scl100, CENP-A/B in non-ILD group
⭐︎ older age, ⚦ sex, heavy 🚬
⭐︎ ↑ WBC, CRP, RF
#ACRBest @Rheumnow
https://t.co/Yo4jRKqvfV https://t.co/l5gbKoZBkm
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
What increases risk of RA-assoc #bronchiectasis, separate from #RA-ILD?
Results from @BrighamResearch find seropositivity (esp high +ve RF/CCP), older age, disease duration, & low BMI incr. risk of isolated bronchiectasis in RA.
#ACR21 Abs#0288 @RheumNow
https://t.co/jvvRucqTjL https://t.co/aFCfxrbUdV
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abst#0290:
Ever wonder about other predictors of mortality in pts w/ RA-Lung Disease besides ILD (OR 2.3) or older age?
⭐︎ ↑ mortality associated w/ pleural effusions (OR 3.3)
AND, notably...
⭐︎MTX use was protective (OR 0.4)!!!
@RheumNow
https://t.co/KKRkQVY2pf https://t.co/JsU2Rqzi6R
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
This study looked into the prevalence of subclinical atherosclerosis in #rheumatoidarthritis pts w/n 5 yrs of dx using carotid US.
📌vs. controls, RA pts had ⬆ CPs, cIMT
❗Screen RA pts for CV risk early on in their diagnosis
@RheumNow #ACR21 abs0271 https://t.co/btU6IcM3xb
sheila RHEUMarampa ( View Tweet)
#ACR21 Abst#0293
RA patients with lung disease have increased rates of SSc-specific autoantibodies compared to RA w/o lung disease.
▶️ Suggests we may need to investigate further into overlap phenotype in RA-ILD
@Rheumnow https://t.co/04FFuBUKmA https://t.co/A83kaie2gr
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr Doliner @zach_wallace_md on ILD in AAV. ILD in 13% - of which 76% fibrotic. UIP most common. Most MPO+, but also rarely seen with PR3+. 47% ⬆️ risk of death. Abstr#0430 #ACR21 @RheumNow https://t.co/6MnxqW92bz
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0289: Predictive score for preclinical RA-ILD based on 4 identified RF:
⭐︎ ⚦ sex (OR 3.9)
⭐︎ MUC5B T-risk allele (OR 3.7)
⭐︎ mean DAS-28 (OR 2.0)
⭐︎ older age at RA onset (1.1)
Obtain HRCT if w/ above (Se ~87%)!
#ACRBest @Rheumnow https://t.co/KKRkQVY2pf https://t.co/wifiTi6vPq
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@jhrheumatology Dr. Petri at #ACR21 Great Debate.
Safety issues with Voclosporin:
1) Nephrotoxicity
2) Infection
3) CV Risk Factors
4) Malignancy
5) Neurologic toxicity
6) Osteoporosis
7) Drug interactions
8) Deaths
9) Pregnancy contraindication
@RheumNow https://t.co/wjluivmKNt
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0170:
↑ epicardial adipose tissue volume predicts new coronary plaque development in the following RA patients:
⋆ <10 yrs dz (OR 5.75)
⋆ 1 cardiac risk (OR 3.4)
⋆ statin < 1 yr (OR 3.3)
⋆ w/o calcification at b/l (OR 2.65)
@Rheumnow
https://t.co/tnyWRVSger https://t.co/uhak4kdbll
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Interesting study on 5yr CV event risk in early #rheumatoidarthritis pts who received T2T mgt shows no difference in CVE risk in ERA grp vs control
ERA cohort:
> Longer remission = protective for CVE
> ⬆ HAQ = predictive of CVE
Tighter control, ⬇ CVEs
@RheumNow #ACR21 abs0282 https://t.co/GG7HPvWd0r
sheila RHEUMarampa ( View Tweet)
Abst#271 #ACR21. RA activity predicts left ventricular mass change in pts without CVD
⭐️35% had abnormal LV geometry at baseline TTE
⭐️55% at f/u TTE 3-6 years later
⭐️Increase in concentric remodeling on LV
@Rheumnow https://t.co/uHnqITcTy9 https://t.co/KmV8volVwd
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0276:
Pulse pressure (PP) = Systolic BP - Diastolic BP, measures arterial compliance
⭐️RA: higher PP than controls
⭐️PP was independent risk factor for subclinical atherosclerosis
▶️ Look at the vitals, we have this at every pt visit!
@Rheumnow https://t.co/KZaf1AwO6Q https://t.co/kN4xGxWiV9
Links:
Eric Dein ericdeinmd ( View Tweet)
