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      Cardiovascular risk in myositis patients compared with the general population

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          Abstract

          Objectives

          We aimed to evaluate cardiovascular (CV) risk in patients with idiopathic inflammatory myopathies (IIM) compared with healthy controls (HC) and to assess its association with disease-specific features.

          Methods

          Ninety IIM patients and 180 age-/sex-matched HC were included. Subjects with a history of CV disease (angina pectoris, myocardial infarction and cerebrovascular/peripheral arterial vascular events) were excluded. All participants were prospectively recruited and underwent examinations of carotid intima–media thickness (CIMT), pulse wave velocity (PWV), ankle-brachial index (ABI), and body composition. The risk of fatal CV events was evaluated by the Systematic COronary Risk Evaluation (SCORE) and its modifications.

          Results

          Compared with HC, IIM patients had a significantly higher prevalence of traditional CV risk factors, carotid artery disease (CARD), abnormal ABI and PWV. After propensity score matching (using traditional CV risk factors), the prevalence of CARD and pathological PWV remained significantly higher in IIM than HC. No significant difference in SCORE was observed. The most unfavourable CV risk profile was observed in patients with necrotizing myopathy, especially in statin-induced anti-HMGCR + patients. The calculated CV risk scores by SCORE, SCORE2 and SCORE multiplied by the coefficient 1.5 (mSCORE) were reclassified according to CIMT and the presence of carotid plaques. SCORE was demonstrated to be most inaccurate in predicting CV risk in IIM. Age, disease activity, lipid profile, body composition parameters and blood pressure were the most significant predictors of CV risk in IIM patients.

          Conclusion

          Significantly higher prevalence of traditional risk factors and subclinical atherosclerosis was observed in IIM patients compared with HC.

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          Most cited references48

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          2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

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            2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension

            : Document reviewers: Guy De Backer (ESC Review Co-ordinator) (Belgium), Anthony M. Heagerty (ESH Review Co-ordinator) (UK), Stefan Agewall (Norway), Murielle Bochud (Switzerland), Claudio Borghi (Italy), Pierre Boutouyrie (France), Jana Brguljan (Slovenia), Héctor Bueno (Spain), Enrico G. Caiani (Italy), Bo Carlberg (Sweden), Neil Chapman (UK), Renata Cifkova (Czech Republic), John G. F. Cleland (UK), Jean-Philippe Collet (France), Ioan Mircea Coman (Romania), Peter W. de Leeuw (The Netherlands), Victoria Delgado (The Netherlands), Paul Dendale (Belgium), Hans-Christoph Diener (Germany), Maria Dorobantu (Romania), Robert Fagard (Belgium), Csaba Farsang (Hungary), Marc Ferrini (France), Ian M. Graham (Ireland), Guido Grassi (Italy), Hermann Haller (Germany), F. D. Richard Hobbs (UK), Bojan Jelakovic (Croatia), Catriona Jennings (UK), Hugo A. Katus (Germany), Abraham A. Kroon (The Netherlands), Christophe Leclercq (France), Dragan Lovic (Serbia), Empar Lurbe (Spain), Athanasios J. Manolis (Greece), Theresa A. McDonagh (UK), Franz Messerli (Switzerland), Maria Lorenza Muiesan (Italy), Uwe Nixdorff (Germany), Michael Hecht Olsen (Denmark), Gianfranco Parati (Italy), Joep Perk (Sweden), Massimo Francesco Piepoli (Italy), Jorge Polonia (Portugal), Piotr Ponikowski (Poland), Dimitrios J. Richter (Greece), Stefano F. Rimoldi (Switzerland), Marco Roffi (Switzerland), Naveed Sattar (UK), Petar M. Seferovic (Serbia), Iain A. Simpson (UK), Miguel Sousa-Uva (Portugal), Alice V. Stanton (Ireland), Philippe van de Borne (Belgium), Panos Vardas (Greece), Massimo Volpe (Italy), Sven Wassmann (Germany), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain).The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.
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              Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project.

              The SCORE project was initiated to develop a risk scoring system for use in the clinical management of cardiovascular risk in European clinical practice. The project assembled a pool of datasets from 12 European cohort studies, mainly carried out in general population settings. There were 20,5178 persons (88,080 women and 11,7098 men) representing 2.7 million person years of follow-up. There were 7934 cardiovascular deaths, of which 5652 were deaths from coronary heart disease. Ten-year risk of fatal cardiovascular disease was calculated using a Weibull model in which age was used as a measure of exposure time to risk rather than as a risk factor. Separate estimation equations were calculated for coronary heart disease and for non-coronary cardiovascular disease. These were calculated for high-risk and low-risk regions of Europe. Two parallel estimation models were developed, one based on total cholesterol and the other on total cholesterol/HDL cholesterol ratio. The risk estimations are displayed graphically in simple risk charts. Predictive value of the risk charts was examined by applying them to persons aged 45-64; areas under ROC curves ranged from 0.71 to 0.84. The SCORE risk estimation system offers direct estimation of total fatal cardiovascular risk in a format suited to the constraints of clinical practice.
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                Author and article information

                Contributors
                Journal
                Rheumatology (Oxford)
                Rheumatology (Oxford)
                brheum
                Rheumatology (Oxford, England)
                Oxford University Press
                1462-0324
                1462-0332
                March 2024
                05 June 2023
                05 June 2023
                : 63
                : 3
                : 715-724
                Affiliations
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University , Prague, Czech Republic
                Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University , Prague, Czech Republic
                Department of Human Movement Laboratory, Faculty of Physical Education and Sport, Charles University , Prague, Czech Republic
                Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague , Kladno, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Institute of Rheumatology , Prague, Czech Republic
                Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic
                Author notes
                Correspondence to: Michal Tomčík, Institute of Rheumatology, Na Slupi 4, 128 50 Prague 2, Czech Republic. E-mail: tomcik@ 123456revma.cz

                M.V. and M.T. contributed equally.

                Author information
                https://orcid.org/0000-0002-9912-725X
                https://orcid.org/0000-0002-6416-8385
                https://orcid.org/0000-0001-9346-6640
                https://orcid.org/0000-0001-6247-7152
                https://orcid.org/0000-0001-8690-3427
                https://orcid.org/0000-0003-3680-3326
                https://orcid.org/0000-0002-6068-4948
                https://orcid.org/0000-0002-9283-3661
                https://orcid.org/0000-0002-9114-2172
                https://orcid.org/0000-0002-1314-1123
                https://orcid.org/0000-0001-5492-9788
                https://orcid.org/0000-0003-1952-8422
                https://orcid.org/0000-0001-5500-7312
                https://orcid.org/0000-0002-4243-235X
                https://orcid.org/0000-0002-0851-0713
                https://orcid.org/0000-0002-7226-1926
                https://orcid.org/0000-0002-8616-7850
                Article
                kead271
                10.1093/rheumatology/kead271
                10907818
                37279728
                dbeaba42-106f-48ab-a6eb-e9e384bcc232
                © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 12 January 2023
                : 31 May 2023
                : 20 June 2023
                Page count
                Pages: 10
                Funding
                Funded by: Ministry of Health of the Czech Republic, DOI 10.13039/501100003243;
                Award ID: 023728
                Award ID: NV18-01-00161A
                Award ID: NU21-01-00146
                Funded by: Ministry of Education Youth and Sports of the Czech Republic;
                Award ID: SVV 260638
                Award ID: BBMRI.cz-LM2023033
                Funded by: Charles University Grant Agency, DOI 10.13039/100007543;
                Award ID: GAUK 312218
                Categories
                Clinical Science
                AcademicSubjects/MED00360

                Rheumatology
                atherosclerosis,cardiovascular risk,myositis,inflammation
                Rheumatology
                atherosclerosis, cardiovascular risk, myositis, inflammation

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