Clinical profile and outcome of patients with chronic inflammatory arthritis and metabolic syndrome
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Clinical profile and outcome of patients with chronic inflammatory arthritis and metabolic syndrome Giovanni Cioffi1 · Ombretta Viapiana1 · Luigi Tarantini2 · Giovanni Orsolini1 · Luca Idolazzi1 · Federica Ognibeni Sonographer · Andrea Dalbeni3 · Davide Gatti1 · Angelo Fassio1 · Maurizio Rossini1 · Alessandro Giollo1 Received: 20 June 2020 / Accepted: 25 September 2020 © The Author(s) 2020
Abstract Systemic chronic inflammation may favor the onset of metabolic syndrome (MetS) which represents a risk factor for CV events. Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are disorders with high prevalence of MetS. We assessed the factors associated with MetS and its prognostic role in non-selected RA/AS/PsA patients. Between March 2014 and April 2016, 458 patients (228 RA, 134 PsA, 96 AS) selected for a primary prevention program for cardiovascular diseases were analyzed. Primary and co-primary end points were a composite of all-cause death/allcause hospitalization and CV death/CV hospitalization, respectively. MetS was diagnosed according to the IDF Task Force on Epidemiology and Prevention. Patients were divided into MetS + (73 = 16%) and MetS − (385 = 84%). At multivariate logistic analysis, cancer, moderate/high disease activity, higher LV mass (LVM) and degree of LV diastolic dysfunction were independently associated with MetS. At 36-month follow-up, the event rate for primary/co-primary end point was 52/15% in MetS + vs 23/7% in MetS − (both p 18 years of age in stable sinus rhythm with RA diagnosed according to the 2010 ACR/EULAR classification criteria [25], PsA and AS diagnosed by the CASPAR and the ASAS criteria as recently summarized by Rudwaleit and Taylor [26]. Participants were consecutively recruited from March 2014 to April 2016 at the Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona (Italy). They underwent clinical, laboratory and echocardiographic evaluations as part of a primary prevention program for CV diseases. Exclusion criteria were the presence of symptoms/signs of cardiac disease, a history of myocardial infarction, myocarditis or heart failure, coronary heart disease diagnosed by clinical, electrocardiographic evaluation at rest and by the results of exercise/scintigraphy/echo-stress test, alcoholic or primary hypertrophic cardiomyopathy, prior myocardial revascularization, significant valve heart disease and atrial fibrillation. All patients gave written informed consent signing a specific institutional consent form; the study was approved by Ethical Committees of the Verona University and conforms to the ethical guidelines of the Declaration of Helsinki as revised in 2000.
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Internal and Emergency Medicine
Definitions Metabolic syndrome was diagnosed according to the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention (National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federat
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