A Better Assessment Tool For Heart-Disease Risk

By Jane Farrell

An international team of researchers has created a heart disease risk assessment tool designed to better evaluate the likelihood of heart disease in patients with rheumatoid arthritis.

People with rheumatoid arthritis are twice as likely as the average person to develop heart problems. But until now, pinpointing which RA patients are at risk has been difficult, because the usual heart disease risk assessment tool may underrate the dangers these patients face.

Details on the new method, known as the Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis, or ATACC-RA, were presented at the annual meeting of the European League Against Rheumatism in Paris. Researchers involved in the study included physicians from institutions in the U.S., Canada, Mexico, South Africa and Europe. The Mayo Clinic in Rochester, Minnesota, is gathering and analyzing the group’s data.

The team analyzed statistics from patients who took standard heart disease risk assessments such as the Framingham tool. The results differed sharply of 314 rheumatoid arthritis patients studied who eventually developed heart problems, Framingham classified 54 percent, or 168 people, as high risk; ATACC-RA identified 201, or 64 percent, as high risk.

“There are completely new factors that are considered,” says co-author Sherine Gabriel, M.D., a rheumatologist and epidemiologist at Mayo. “What’s unique about this calculator is that it incorporates rheumatoid arthritis disease characteristics into the assessment of cardiovascular risk.”

The ATACC-RA calculator is designed to predict RA patients’ chances of developing heart disease within 10 years. The group plans further work to test and refine the calculator so it can be personalized for patients.
Gabriel suggested that patients with RA suggest that their rheumatologist work with a cardiologist to provide the best risk assessment.

Last year, the Mayo Clinic established a Cardioi-Rheumatology Clinic to prevent heart disease in patients with chronic inflammatory forms of arthritis and to catch it early if it develops.