Vertebral fracture assessment-detected abdominal aortic calcification and cardiovascular disease in rheumatoid arthritis

Ausaf Mohammad, Derek Lohan, Diane Bergin, Sarah Mooney, John Newell, Martin O' Donnell, Shreyasee Amin, Robert J. Coughlan, John J. Carey

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: Individuals with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Traditional prediction tools underestimate this risk. Vertebral fracture assessment (VFA)-detected aortic calcification enhances CVD risk stratification in the general population but its relationship in RA is unclear. We assessed the presence of abdominal aortic calcification (AAC) on VFA images, and its association with CVD in RA patients. Methods: We determined the prevalence of cardiovascular events in a cohort of RA patients aged 40 years and older fulfilling the 1987 American College of Rheumatology classification criteria. Two blinded radiologists independently reviewed all VFA scans to determine the presence/severity of AAC using an established 24-point scale. Logistic regression analyses were performed to determine whether AAC could discriminate between RA patients with and without CVD, and to compare the ability of VFA-detected AAC to predict CVD to conventional CVD risk factors and the Framingham Risk Score. Results: 603 subjects fulfilled study inclusion criteria. 230 (38%) subjects had 1 or more documented CVD event and 211 (35%) had AAC detected on VFA scans. Significantly more subjects with cardiovascular events had AAC on their VFA scans than controls (76% versus 10%; P < 0.05). VFA-detected AAC was a better predictor of CVD than traditional risk factors, and significantly out-performed the Framingham Risk Score for discriminating between the presence and absence of CVD (AUC 0.85 versus 0.58; P < 0.001). Conclusion: There was a significant association between VFA-detected AAC and CVD in our study population. This finding may enhance cardiovascular disease risk prediction in RA patients.

Original languageEnglish (US)
Pages (from-to)632-637
Number of pages6
JournalSeminars in Arthritis and Rheumatism
Volume43
Issue number5
DOIs
StatePublished - 2014

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Aortic Diseases
Rheumatoid Arthritis
Cardiovascular Diseases
Population
Area Under Curve
Logistic Models
Regression Analysis

Keywords

  • Abdominal aortic calcification
  • Cardiovascular disease
  • Framingham risk score
  • Rheumatoid arthritis
  • Vertebral fracture assessment

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

Vertebral fracture assessment-detected abdominal aortic calcification and cardiovascular disease in rheumatoid arthritis. / Mohammad, Ausaf; Lohan, Derek; Bergin, Diane; Mooney, Sarah; Newell, John; O' Donnell, Martin; Amin, Shreyasee; Coughlan, Robert J.; Carey, John J.

In: Seminars in Arthritis and Rheumatism, Vol. 43, No. 5, 2014, p. 632-637.

Research output: Contribution to journalArticle

Mohammad, Ausaf ; Lohan, Derek ; Bergin, Diane ; Mooney, Sarah ; Newell, John ; O' Donnell, Martin ; Amin, Shreyasee ; Coughlan, Robert J. ; Carey, John J. / Vertebral fracture assessment-detected abdominal aortic calcification and cardiovascular disease in rheumatoid arthritis. In: Seminars in Arthritis and Rheumatism. 2014 ; Vol. 43, No. 5. pp. 632-637.
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abstract = "Objective: Individuals with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Traditional prediction tools underestimate this risk. Vertebral fracture assessment (VFA)-detected aortic calcification enhances CVD risk stratification in the general population but its relationship in RA is unclear. We assessed the presence of abdominal aortic calcification (AAC) on VFA images, and its association with CVD in RA patients. Methods: We determined the prevalence of cardiovascular events in a cohort of RA patients aged 40 years and older fulfilling the 1987 American College of Rheumatology classification criteria. Two blinded radiologists independently reviewed all VFA scans to determine the presence/severity of AAC using an established 24-point scale. Logistic regression analyses were performed to determine whether AAC could discriminate between RA patients with and without CVD, and to compare the ability of VFA-detected AAC to predict CVD to conventional CVD risk factors and the Framingham Risk Score. Results: 603 subjects fulfilled study inclusion criteria. 230 (38{\%}) subjects had 1 or more documented CVD event and 211 (35{\%}) had AAC detected on VFA scans. Significantly more subjects with cardiovascular events had AAC on their VFA scans than controls (76{\%} versus 10{\%}; P < 0.05). VFA-detected AAC was a better predictor of CVD than traditional risk factors, and significantly out-performed the Framingham Risk Score for discriminating between the presence and absence of CVD (AUC 0.85 versus 0.58; P < 0.001). Conclusion: There was a significant association between VFA-detected AAC and CVD in our study population. This finding may enhance cardiovascular disease risk prediction in RA patients.",
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AU - Mohammad, Ausaf

AU - Lohan, Derek

AU - Bergin, Diane

AU - Mooney, Sarah

AU - Newell, John

AU - O' Donnell, Martin

AU - Amin, Shreyasee

AU - Coughlan, Robert J.

AU - Carey, John J.

PY - 2014

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N2 - Objective: Individuals with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Traditional prediction tools underestimate this risk. Vertebral fracture assessment (VFA)-detected aortic calcification enhances CVD risk stratification in the general population but its relationship in RA is unclear. We assessed the presence of abdominal aortic calcification (AAC) on VFA images, and its association with CVD in RA patients. Methods: We determined the prevalence of cardiovascular events in a cohort of RA patients aged 40 years and older fulfilling the 1987 American College of Rheumatology classification criteria. Two blinded radiologists independently reviewed all VFA scans to determine the presence/severity of AAC using an established 24-point scale. Logistic regression analyses were performed to determine whether AAC could discriminate between RA patients with and without CVD, and to compare the ability of VFA-detected AAC to predict CVD to conventional CVD risk factors and the Framingham Risk Score. Results: 603 subjects fulfilled study inclusion criteria. 230 (38%) subjects had 1 or more documented CVD event and 211 (35%) had AAC detected on VFA scans. Significantly more subjects with cardiovascular events had AAC on their VFA scans than controls (76% versus 10%; P < 0.05). VFA-detected AAC was a better predictor of CVD than traditional risk factors, and significantly out-performed the Framingham Risk Score for discriminating between the presence and absence of CVD (AUC 0.85 versus 0.58; P < 0.001). Conclusion: There was a significant association between VFA-detected AAC and CVD in our study population. This finding may enhance cardiovascular disease risk prediction in RA patients.

AB - Objective: Individuals with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Traditional prediction tools underestimate this risk. Vertebral fracture assessment (VFA)-detected aortic calcification enhances CVD risk stratification in the general population but its relationship in RA is unclear. We assessed the presence of abdominal aortic calcification (AAC) on VFA images, and its association with CVD in RA patients. Methods: We determined the prevalence of cardiovascular events in a cohort of RA patients aged 40 years and older fulfilling the 1987 American College of Rheumatology classification criteria. Two blinded radiologists independently reviewed all VFA scans to determine the presence/severity of AAC using an established 24-point scale. Logistic regression analyses were performed to determine whether AAC could discriminate between RA patients with and without CVD, and to compare the ability of VFA-detected AAC to predict CVD to conventional CVD risk factors and the Framingham Risk Score. Results: 603 subjects fulfilled study inclusion criteria. 230 (38%) subjects had 1 or more documented CVD event and 211 (35%) had AAC detected on VFA scans. Significantly more subjects with cardiovascular events had AAC on their VFA scans than controls (76% versus 10%; P < 0.05). VFA-detected AAC was a better predictor of CVD than traditional risk factors, and significantly out-performed the Framingham Risk Score for discriminating between the presence and absence of CVD (AUC 0.85 versus 0.58; P < 0.001). Conclusion: There was a significant association between VFA-detected AAC and CVD in our study population. This finding may enhance cardiovascular disease risk prediction in RA patients.

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KW - Cardiovascular disease

KW - Framingham risk score

KW - Rheumatoid arthritis

KW - Vertebral fracture assessment

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