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Ionescu M, Ionescu P, Suceveanu AP, Stoian AP, Motofei I, Ardeleanu V, Parepa IR. Cardiovascular risk estimation in young patients with ankylosing spondylitis: A new model based on a prospective study in Constanta County, Romania. Exp Ther Med 2021; 21:529. [PMID: 33815602 DOI: 10.3892/etm.2021.9961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular (CV) risk assessment charts are useful in establishing a patient therapeutic plan, but the most commonly used charts have essential limitations when applied to special populations. Our aim was to determine whether the Systematic Coronary Risk Evaluation (SCORE) chart underestimates the CV risk in young patients with ankylosing spondylitis (AS) and to promote the necessity of new risk assessment models. We conducted a prospective study in Constanta County, Romania including 70 consecutive patients ≤50 years of age, previously diagnosed with AS, without a history of established CV disease, diabetes mellitus and chronic kidney disease. We estimated the CV risk using SCORE based on total cholesterol, applied for a high-risk population, such as the Romanian population. Estimation of CV risk was also conducted with the relative risk (RR) chart, considering the following variables: Smoking, systolic blood pressure and total cholesterol. The majority of patients (n=46, 65.71%) had low risk according to the SCORE chart and only 24 (34.28%) were found to have moderate CV risk; none of them with high or very high CV risk. Ten patients (21.74%) of the 46 who were considered to have a low risk based on the SCORE system presented with carotid plaques. Twelve patients (50%) of the remaining 24 with moderate CV risk were found to have carotid plaques. According to 2016 'European Society of Cardiology' (ESC) guidelines, 22 of all 70 patients were at high/very high CV risk due to the presence of carotid plaques. Comparing the RR chart with carotid plaque detection, only 4 out of 30 (13.3%) patients with RR=1 had carotid plaques; the frequency was higher in those with RR>1. Our results attested that the SCORE system underestimates the risk in patients with carotid plaques. Carotid ultrasound provided a more heightened sensitivity of the RR chart. C-reactive protein (CRP) >3 mg/dl is associated with RR>1, making this chart a better CV risk predictive system in this particular category of patients.
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Affiliation(s)
- Mihaela Ionescu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania
| | - Paris Ionescu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania
| | - Adrian Paul Suceveanu
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania
| | - Anca Pantea Stoian
- Department of Metabolic Diseases, Clinical Emergency Hospital, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania
| | - Ion Motofei
- Department of Metabolic Diseases, Clinical Emergency Hospital, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania
| | - Valeriu Ardeleanu
- Doctoral School, Faculty of Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania.,Department of Anatomy, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University of Galati, 800008 Galati, Romania.,Department of Surgery, General Hospital C. F. Galati, 800223 Galati, Romania
| | - Irinel-Raluca Parepa
- Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania
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Affiliation(s)
- Evangelista Rocha
- Serviço de Cardiologia, Hospital das Forças Armadas - Pólo de Lisboa, Lisboa, Portugal.
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Cardiovascular risk scores: Usefulness and limitations. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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