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Statin use in rheumatoid arthritis in relation to actual cardiovascular risk: evidence for substantial under treatment of lipid associated cardiovascular risk?
Annals of Rheumatic Diseases, 11/10/09

Toms TE et al. – Depending on the risk stratification method, 2%-26% of RA patients without CVD have sufficiently high risk to require statin therapy, yet most of them remain untreated. To address this issue, we would recommend annual systematic screening using the nationally applicable risk calculator, combined with regular audit of whether treatment targets have been achieved.

Methods

Cohort of 400 well-characterised RA patients
Patients at high CVD risk (excluding patients with established CVD or diabetes)
Applyed risk calculators with or without x1.5 multiplier in specific patient subgroups
Actual statin use versus numbers eligible for statins also calculated

Results

Percentage of patients identified as being at risk ranged significantly depending on method
1.6% (for 20% threshold global CVD risk)
15.5% (for CVD and cerebrovascular morbidity and mortality)
21.8% (for 10% global CVD risk)
25.9% (for 5% CVD mortality)
Majority (58.1%-94.8%) not receiving statins

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