Heart Disease Risk Tool Tailored to Rheumatoid Arthritis Patients
It has been known that people with rheumatoid arthritis are twice as likely to develop heart problems than the general population. But pinpointing patients who need stepped-up heart disease prevention efforts has been a challenge for physicians who treat rhuematoid arthritis. To help aid in diagnosis, an international group of researchers have created a heart disease risk calculator tailored to rheumatoid arthritis patients.
Studies of the new method, known as the Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis, or ATACC-RA, have found that the new calculator is more effective for rheumatoid arthritis patients than standard heart disease risk calculators such as the Framingham and SCORE risk assessment tools.
In a study of 314 rheumatoid arthritis patients studied who eventually developed heart problems, the Framingham tool classified 54%, or 168 people, as high risk, while the ATACC-RA identified 201, or 64%, as high risk.
“There are completely new factors that are considered,” said Sherine Gabriel, MD, a rheumatologist and epidemiologist at Mayo Clinic in Rochester, MN, who was part of the international team of physicians to develop and study the new tool. “What’s unique about this calculator is that it incorporates rheumatoid arthritis disease characteristics into the assessment of cardiovascular risk.”
The major predictors of heart disease in rheumatoid arthritis have more to do with the rheumatoid arthritis itself, including the disease, inflammation, and perhaps treatments, that typical risk factors seen in the general population, said Dr. Gabriel. The new risk tool includes such factors; the Framingham and SCORE calculators do not.
The ATACC-RA calculator is designed to accurately predict rheumatoid arthritis patients’ chances of developing heart disease within 10 years. The group plans further work to test and refine the calculator so it can be personalized for patients, noted Dr. Gabriel, who is working with Mayo biostatistician Cynthia Crowson on the project.
May Benefit Other Arthritis Patients
The risk tool could also benefit people with other inflammatory rheumatic diseases that carry higher heart disease risk, such as lupus and psoriatic arthritis. The current international work to develop a better calculator is just part of the picture when it comes to stopping heart disease in rheumatoid arthritis patients. It is important for patients and physicians to be proactive, Dr. Gabriel said.
“I think it’s important for patients with rheumatoid arthritis to understand that their disease alone carries added risk of heart disease and discuss that with their rheumatologist and perhaps suggest that their rheumatologist work with a cardiologist or a preventive cardiology clinic to come up with a plan to reduce cardiovascular risk,” noted Dr. Gabriel.
According to a press release from the Mayo, the clinic has established a Cardio-Rheumatology Clinic to prevent heart disease in patients with chronic inflammatory forms of arthritis and to catch it early if it develops.