AB0567 USING Q-RISK SCALE FOR CHECKING CARDIOVASCULAR RISK IN PATIENTS WITH PSORIATIC ARTHRITIS

Background:Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is a growing evidence suggesting that patients with PsA also have increased risk of clinical and subclinical cardiovascular disease (CVD), mostly due to endothelial dysfunction and accelerated atherosclerosis, which are the main causes of elevated mortality rate among patients with PsA. For prevention and monitoring progression of CVD in clinical practice scale SCORE usually used, but it isn’t adapted for checking in patients with autoimmune diseases and can be used only for patients after forty years old.Objectives:To check a cardiovascular risk in patient with PsA using Q-risk scale.Methods:In total, ninety-four patients with PsA, who fulfilled the disease criteria (CASPAR) were examined using standard diagnostic methods (including C-reactive protein, lipid profile). The QRISK-3 and SCORE scales were used to assess the 10-year risk of CVD.Results:Intermediate (12.4 ± 0,75 %) risk of adverse cardiovascular events within the next 10 years was estimated for PsA patients and it was 7 to 8 – fold higher than the Q - score of a healthy age, sex, and ethnicity – matched subjects. Using classical SCORE, the risk was estimated as low (1,9±0.24 %). Healthy Heart Age was about 25 % higher than predicted as assessed by QRISK.Conclusion:The Q-risk Scale considers not only classical of such risk factors as age, sex, smoking, systolic blood pressure, total cholesterol (which used SCORE) but also index of atherogenity, BMI, family history of coronary artery disease, treatment with antihypertensive drugs and glucocorticosteroids, comorbidity, systemic inflammatory disease and can be used for different age groups and ethnicity.Q-risk scale appears to be adaptive and informative in patients with chronic inflammatory and autoimmune diseases as compared with SCORE, because it uses mostly all important etiological and trigger factors of CVD especially presence autoimmune inflammatory process in our case.References:[1]Abrar Ahmed Wagan. Cardiovascular risk score in Rheumatoid Arthritis. Pak J Med Sci, Vol. 32, Issue 3, 2016, P.534-538;[2]Frank Verhoeven, Clément Prati. Cardiovascular risk in psoriatic arthritis, a narrative review. Joint Bone Spine, Vol. 87, Issue 5, 2020, P.413-418;[3]Julia Hippisley-Cox, Carol Coupland. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ, Vol. 23, 2017, P.357;[4]Naveen Garg, Subrat K. Muduli. Comparison of different cardiovascular risk score calculators for cardiovascular risk prediction and guideline recommended statin uses. Indian Heart J, Vol. 69, Issue 4, 2017, P.458-463;Disclosure of Interests:None declared.

Cardiovascular Risk Profile of Apparently Healthy Workers in a Tertiary Hospital in Nigeria

Background: Cardiovascular disease incidence is rising in Nigeria. This study was done to identify cardiovascular risk factors and assess the 10-year cardiovascular risk score of healthcare workers of a tertiary hospital in south-western Nigeria. Materials & Methods: In this cross-sectional study, apparently healthy workers of a tertiary hospital in Nigeria were studied. Fifty-two individuals were recruited into the study. Anthropometric measures, blood pressure, fasting lipid profile and HbA1c were obtained using the standard protocols. QRISK3 score was also calculated. Results: The Mean±SD age of participants was 44.9±8.1 years. Dyslipidaemia was the most common risk factor among apparently healthy healthcare workers, while glucose intolerance was the least common. Also, 48.1% of the subjects had at least one cardiovascular risk factor and 15.4% had 3 or more cardiovascular risk factors. The 10-year cardiovascular risk using QRISK3 was moderate in 3.8%. There was no statistically significant difference in the 10-year cardiovascular risk score between the clinical and non-clinical healthcare workers (P=0.313; t=0.819). However, male participants had a significantly higher 10-year cardiovascular risk score compared with the females (3.50 vs. 1.56; P<0.001; t=3.741). Conclusion: Cardiovascular risk factors are prevalent among health workers and closer attention needs to be paid to these factors by the hospital management to mitigate cardiovascular disease among the staff.

Fibrinogen and hemoglobin predict near future cardiovascular events in asymptomatic individuals

To identify circulating proteins predictive of acute cardiovascular disease events in the general population, we performed a proteomic screen in plasma from asymptomatic individuals. A “Discovery cohort” of 25 individuals who subsequently incurred a cardiovascular event within 3 years (median age = 70 years, 80% male) was matched to 25 controls remaining event-free for > 5 years (median age = 72 years, 80% male). Plasma proteins were assessed by data independent acquisition mass spectrometry (DIA-MS). Associations with cardiovascular events were tested using Cox regression, adjusted for the New Zealand Cardiovascular Risk Score. Concentrations of leading protein candidates were subsequently measured with ELISAs in a larger (n = 151) independent subset. In the Discovery cohort, 76 plasma proteins were robustly quantified by DIA-MS, with 8 independently associated with cardiovascular events. These included (HR = hazard ratio [95% confidence interval] above vs below median): fibrinogen alpha chain (HR = 1.84 [1.19–2.84]); alpha-2-HS-glycoprotein (also called fetuin A) (HR = 1.86 [1.19–2.93]); clusterin isoform 2 (HR = 1.59 [1.06–2.38]); fibrinogen beta chain (HR = 1.55 [1.04–2.30]); hemoglobin subunit beta (HR = 1.49 [1.04–2.15]); complement component C9 (HR = 1.62 [1.01–2.59]), fibronectin isoform 3 (HR = 0.60 [0.37–0.99]); and lipopolysaccharide-binding protein (HR = 1.58 [1.00–2.49]). The proteins for which DIA-MS and ELISA data were correlated, fibrinogen and hemoglobin, were analyzed in an Extended cohort, with broader inclusion criteria and longer time to events, in which these two proteins were not associated with incident cardiovascular events. We have identified eight candidate proteins that may independently predict cardiovascular events occurring within three years in asymptomatic, low-to-moderate risk individuals, although these appear not to predict events beyond three years.

Association of Low Systolic Blood Pressure with Postmortem Amyloid-β and Tau

Background: Vascular mechanisms may contribute to the accumulation of AD pathology. Objective: We examined whether the burden of vascular risk factors proximate to death is associated with amyloid-β and tau levels or modified their known association. Methods: We examined the brains of 1, 585 participants from two longitudinal community-based studies of older adults. Amyloid-β and tau were quantified by postmortem examination. The burden of vascular risk factors was summarized by calculating the Framingham general cardiovascular risk score (FRS) proximate to death. Using linear regressions, we examined the association of the FRS with the amyloid-β and tau levels and examined if the FRS modified the association of the amyloid-β with tau. Results: On average, participants were nearly 90 years old and two-thirds were women. The FRS was not associated with amyloid-β (Spearman r = –0.00, p = 0.918) or tau (r = 0.01, p = 0.701). However, the FRS as a whole (estimate = –0.022, SE = 0.008, p = 0.009), and specifically the systolic blood pressure (SBP) component (estimate = –0.033, SE = 0.012, p = 0.009), modified the association of the amyloid-β with tau. Further analysis showed that the association between amyloid-β and tau was stronger at lower levels of SBP. Conclusion: Late-life vascular risk scores were not related to postmortem levels of amyloid-β or tau. However, lower levels of vascular risk scores and SBP were associated with a stronger association between amyloid-β and tau. These data suggest that vascular risk factors may modify the relation of AD pathology markers to one another.

The influence of specific aspects of occupational stress on security guards’ health and work ability: detailed extension of a previous study

In our earlier study of security guards, we showed that higher occupational stress was associated with health impairments (metabolic syndrome, diabetes, hypertension, cardiovascular diseases) and work disability. The aim of this study was to further explore the association of specific occupational stressors with health impairments and work disability parameters in 399 Serbian male security guards (aged 25–65 years). Ridge linear regression analysis revealed that, after controlling for age, body mass index, and smoking status, professional stressors including high demands, strictness, conflict/uncertainty, threat avoidance and underload were significant positive predictors of fasting glucose, triglycerides, total and LDL cholesterol, blood pressure, heart rate, Framingham cardiovascular risk score, and temporary work disability. The security profession is in expansion worldwide, and more studies are needed to establish precise health risk predictors, since such data are generally lacking.