RESEARCH - Indiciations for lowering LDL cholesterol in RA: an unrecognized problem

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J Rheumatol. 2006 Jul 15; [Epub ahead of print] Related Articles,

Indications for Lowering LDL Cholesterol in Rheumatoid Arthritis: An

Unrecognized Problem.

Soubrier M, Zerkak D, Dougados M.

From Service de Rhumatologie, H open dot in circlepital G. Montpied,

Clermont-Ferrand; and Universite Rene Descartes, AP-HP Hopital Cochin,

Paris, France.

OBJECTIVE: To evaluate the prevalence of patients with rheumatoid arthritis

(RA) in whom lowering low density lipoprotein cholesterol (LDL-C) should be

considered in accord with the ATPIII guidelines. The treatment goals are

based on the number of risk factors (RF) other than LDL-C. The goal for 0-1

RF is < 160 mg/l, for multiple RF < 130 mg/l, and < 100 mg/l for coronary

heart disease (CHD) or CHD risk equivalent (other clinical atherosclerotic

diseases and diabetes mellitus). METHODS: A cross-sectional study was

conducted in 145 patients with RA. We recorded the patients'

characteristics, the potential risk factors for CHD, and results of lipid

profile tests [total cholesterol (TC), high density lipoprotein cholesterol,

and LDL-C]. RESULTS: Of the 145 patients recruited, 23 had LDL-C lowering

therapy. Of the remaining 122 patients (mean age 54 +/- 15 years), of whom

101 (83%) were women, 109 were taking a disease modifying antirheumatic

drug. At the time of the study, disease duration was 12 +/- 10 years.

Twenty-seven (22%) of the 122 patients needed lowering of LDL-C. If RA was

considered as an additional risk factor or a major risk factor, like

diabetes mellitus, 35 patients (29%) and 86 (70%) patients, respectively,

needed lowering therapy.

CONCLUSION: Our study shows the high percentage of patients with RA for whom

LDL-C intervention should be considered. As cardiovascular morbidity and

mortality is increased in patients with RA, it would be useful to determine

whether RA should be considered as an independent cardiovascular risk factor

or as a major risk factor like diabetes that warrants more aggressive

cardiac prevention measures.

PMID: 16845709

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6845709

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