Effect of thrombocytosis on cardiovascular risk in rheumatoid arthritis

Abstract

BACKGROUND: Patients with rheumatoid arthritis have a high level of comorbidity, and their most common and socially significant conditions are cardiovascular diseases, which represent a major cause of mortality. Currently, there are no data on the differences in cardiovascular risk scales in patients with rheumatoid arthritis depending on the presence or absence of thrombocytosis.

AIM: To assess and compare cardiovascular risk according to conventional scales in patients with thrombocytosis and normal thrombocytes.

MATERIALS AND METHODS: The study involved 85 patients diagnosed with rheumatoid arthritis: 40 with thrombocytosis [including 25 (62,5%) women] and 45 with normal thrombocytes [including 29 (64,4%) women]. The following scales were used to assess risk of cardiovascular complications: Systematic COronary Risk Evaluation with adjustment factor 1.5 (mSCORE), Reynolds Risk Score (RRS), QRESEARCH Cardiovascular Risk Algorithm (QRISK3), Assessing Cardiovascular Risk to Scottish Intercollegiate Guidelines Network / SIGN to Assign Preventative Treatment (ASSIGN).

RESULTS: The obtained findings have demontrated that according to the mSCORE and RRS scales the patients of both groups had almost identical parameters; however, according to the ASSIGN and QRISK3 high risk of cardiovascular complications has been detected nearly twice as frequently in the patients with rheumatoid arthritis and thrombocytosis in comparison with those with normal level of thrombocytes. It is also worth noting that more frequent determination of high risk of cardiovascular complications by the QRISK3 was statistically significant.

CONCLUSIONS: The QRISK3 calculation has shown significantly higher prevalence of high-risk cardiovascular complications among the patients with platelet counts >450 ∙ 10⁹/l compared with those with platelet levels within the reference values. Thus, the QRISK3 scale can be considered as more informative for estimating risk of cardiovascular complications in rheumatoid arthritis.

Keywords

rheumatoid arthritis / thrombocytosis / cardiovascular risk / QRISK3

References

[1] Mazurov VI, Gaidukova IZ, Belyaeva IB. Klinicheskaya revmatologiya. Rukovodstvo dlya vrachei. 3rd ed. Moscow: E-noto; 2021. 696 p. (In Russ.)

[2] Мазуров В.И., Гайдукова И.З., Беляева И.Б. Клиническая ревматология. Руководство для врачей / под ред. В.И. Мазурова. 3-е изд., перераб. и доп. Москва: Е-ното, 2021. 696 с.

[3] Pope JE, Choy EH. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin Arthritis Rheum. 2021;51(1):219–229. DOI: 10.1016/j.semarthrit.2020.11.005

[4] Pope J.E., Choy E.H. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities // Semin. Arthritis Rheum. 2021. Vol. 51, No. 1. P. 219–229. DOI: 10.1016/j.semarthrit.2020.11.005

[5] Bombardier C, Barbieri M, Parthan A, et al. The relationship between joint damage and functional disability in rheumatoid arthritis: a systematic review. Ann Rheum Dis. 2012;71(6):836–844. DOI: 10.1136/annrheumdis-2011-200343

[6] Bombardier C., Barbieri M., Parthan A. et al. The relationship between joint damage and functional disability in rheumatoid arthritis: a systematic review // Ann. Rheum. Dis. 2012. Vol. 71, No. 6. P. 836–844. DOI: 10.1136/annrheumdis-2011-200343

[7] Buttgereit F, Smolen JS, Coogan AN, Cajochen C. Clocking in: chronobiology in rheumatoid arthritis. Nat Rev Rheumatol. 2015;11(6):349–356. DOI: 10.1038/nrrheum.2015.31

[8] Buttgereit F., Smolen J.S., Coogan A.N., Cajochen C. Clocking in: chronobiology in rheumatoid arthritis // Nat. Rev. Rheumatol. 2015. Vol. 11, No. 6. P. 349–356. DOI: 10.1038/nrrheum.2015.31

[9] Kim JW, Suh CH. Systemic manifestations and complications in patients with rheumatoid arthritis. J Clin Med. 2020;9(6):2008. DOI: 10.3390/jcm9062008

[10] Kim J.W., Suh C.H. Systemic manifestations and complications in patients with rheumatoid arthritis // J. Clin. Med. 2020. Vol. 9, No. 6. P. 2008. DOI: 10.3390/jcm9062008

[11] Dougados M, Soubrier M, Antunez A, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014;73(1):62–68. DOI: 10.1136/annrheumdis-2013-204223

[12] Dougados M., Soubrier M., Antunez A. et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA) // Ann. Rheum. Dis. 2014. Vol. 73, No. 1. P. 62–68. DOI: 10.1136/annrheumdis-2013-204223

[13] Kannayiram SS, Guraya A, Muojieje CC, et al. An analysis of rheumatoid arthritis hospitalizations. Cureus. 2020;12(12):e12344. DOI: 10.7759/cureus.12344

[14] Kannayiram S.S., Guraya A., Muojieje C.C. et al. An analysis of rheumatoid arthritis hospitalizations // Cureus. 2020. Vol. 12, No. 12. P. e12344. DOI: 10.7759/cureus.12344

[15] van Onna M, Boonen A. The challenging interplay between rheumatoid arthritis, ageing and comorbidities. BMC Musculoskelet Disord. 2016;17:184. DOI: 10.1186/s12891-016-1038-3

[16] van Onna M., Boonen A. The challenging interplay between rheumatoid arthritis, ageing and comorbidities // BMC Musculoskelet. Disord. 2016. Vol. 17. P. 184. DOI: 10.1186/s12891-016-1038-3

[17] England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ. 2018;361:k1036. DOI: 10.1136/bmj.k1036

[18] England B.R., Thiele G.M., Anderson D.R., Mikuls T.R. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications // BMJ. 2018. Vol. 361. P. k1036. DOI: 10.1136/bmj.k1036

[19] Peters MJ, Symmons DP, McCarey D, et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis. 2010;69(2):325–331. DOI: 10.1136/ard.2009.113696

[20] Peters M.J., Symmons D.P., McCarey D. et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis // Ann. Rheum. Dis. 2010. Vol. 69, No. 2. P. 325–331. DOI: 10.1136/ard.2009.113696

[21] Liao KP. Cardiovascular disease in patients with rheumatoid arthritis. Trends Cardiovasc Med. 2017;27(2):136–140. DOI: 10.1016/j.tcm.2016.07.006

[22] Liao K.P. Cardiovascular disease in patients with rheumatoid arthritis // Trends Cardiovasc. Med. 2017. Vol. 27, No. 2. P. 136–140. DOI: 10.1016/j.tcm.2016.07.006

[23] Agca R, Hopman LHGA, Laan KJC, et al. Cardiovascular event risk in rheumatoid arthritis compared with type 2 diabetes: a 15-year longitudinal Study. J Rheumatol. 2020;47(3):316–324. DOI: 10.3899/jrheum.180726

[24] Agca R., Hopman L.H.G.A., Laan K.J.C. et al. Cardiovascular event risk in rheumatoid arthritis compared with type 2 diabetes: a 15-year longitudinal study // J. Rheumatol. 2020. Vol. 47, No. 3. P. 316–324. DOI: 10.3899/jrheum.180726

[25] Ogdie A, Yu Y, Haynes K, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015;74(2):326–332. DOI: 10.1136/annrheumdis-2014-205675

[26] Ogdie A., Yu Y., Haynes K. et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study // Ann. Rheum. Dis. 2015. Vol. 74, No. 2. P. 326–332. DOI: 10.1136/annrheumdis-2014-205675

[27] Cooksey R, Brophy S, Kennedy J, et al. Cardiovascular risk factors predicting cardiac events are different in patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis. Semin Arthritis Rheum. 2018;48(3):367–373. DOI: 10.1016/j.semarthrit.2018.03.005

[28] Cooksey R., Brophy S., Kennedy J. et al. Cardiovascular risk factors predicting cardiac events are different in patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis // Semin. Arthritis Rheum. 2018. Vol. 48, No. 3. P. 367–373. DOI: 10.1016/j.semarthrit.2018.03.005

[29] Pujades-Rodriguez M, Duyx B, Thomas SL, et al. Rheumatoid arthritis and incidence of twelve initial presentations of cardiovascular disease: a population record-linkage cohort study in England. PLoS One. 2016;11(3):e0151245. DOI: 10.1371/journal.pone.0151245

[30] Pujades-Rodriguez M., Duyx B., Thomas S.L. et al. Rheumatoid arthritis and incidence of twelve initial presentations of cardiovascular disease: a population record-linkage cohort study in England // PLoS One. 2016. Vol. 11, No. 3. P. e0151245. DOI: 10.1371/journal.pone.0151245

[31] Al-Ghamdi A, Attar SM. Extra-articular manifestations of rheumatoid arthritis: a hospital-based study. Ann Saudi Med. 2009;29(3):189–193. DOI: 10.4103/0256-4947.51774

[32] Al-Ghamdi A., Attar S.M. Extra-articular manifestations of rheumatoid arthritis: a hospital-based study // Ann. Saudi Med. 2009. Vol. 29, No. 3. P. 189–193. DOI: 10.4103/0256-4947.51774

[33] Ehrenfeld M, Penchas S, Eliakim M. Thrombocytosis in rheumatoid arthritis. Recurrent arterial thromboembolism and death. Ann Rheum Dis. 1977;36(6):579–581. DOI: 10.1136/ard.36.6.579

[34] Ehrenfeld M., Penchas S., Eliakim M. Thrombocytosis in rheumatoid arthritis. Recurrent arterial thromboembolism and death // Ann. Rheum. Dis. 1977. Vol. 36, No. 6. P. 579–581. DOI: 10.1136/ard.36.6.579

[35] Pines A, Kaplinsky N, Olchovsky D, et al. Recurrent transient ischemic attacks associated with thrombocytosis in rheumatoid arthritis. Clin Rheumatol. 1982;1(4):291–293. DOI: 10.1007/BF02032089

[36] Pines A., Kaplinsky N., Olchovsky D. et al. Recurrent transient ischemic attacks associated with thrombocytosis in rheumatoid arthritis // Clin. Rheumatol. 1982. Vol. 1, No. 4. P. 291–293. DOI: 10.1007/BF02032089

[37] Casado Naranjo I, Martin Gonzalez R, Sancho Rieger J, et al. Transient ischaemic attacks associated with thrombocytosis in active rheumatoid arthritis. J Neurol Neurosurg Psychiatry. 1988;51(12):1599. DOI: 10.1136/jnnp.51.12.1599

[38] Casado Naranjo I., Martin Gonzalez R., Sancho Rieger J. et al. Transient ischaemic attacks associated with thrombocytosis in active rheumatoid arthritis // J. Neurol. Neurosurg. Psychiatry. 1988. Vol. 51, No. 12. P. 1599. DOI: 10.1136/jnnp.51.12.1599

[39] Zhu L, Singh M, Lele S, et al. Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus. Lupus Sci Med. 2022;9(1):e000564. DOI: 10.1136/lupus-2021-000564

[40] Zhu L., Singh M., Lele S. et al. Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus // Lupus Sci. Med. 2022. Vol. 9, No. 1. P. e000564. DOI: 10.1136/lupus-2021-000564

[41] Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ. 2017;357:j2099. DOI: 10.1136/bmj.j2099

[42] Hippisley-Cox J., Coupland C., Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study // BMJ. 2017. Vol. 357. P. j2099. DOI: 10.1136/bmj.j2099

[43] Dessein PH, Semb AG. Could cardiovascular disease risk stratification and management in rheumatoid arthritis be enhanced? Ann Rheum Dis. 2013;72(11):1743–1746. DOI: 10.1136/annrheumdis-2013-203911

[44] Dessein P.H., Semb A.G. Could cardiovascular disease risk stratification and management in rheumatoid arthritis be enhanced? // Ann. Rheum. Dis. 2013. Vol. 72, No. 11. P. 1743–1746. DOI: 10.1136/annrheumdis-2013-203911

[45] Colaco K, Ocampo V, Ayala AP, et al. Predictive utility of cardiovascular risk prediction algorithms in inflammatory rheumatic diseases: a systematic review. J Rheumatol. 2020;47(6):928–938. DOI: 10.3899/jrheum.190261

[46] Colaco K., Ocampo V., Ayala A.P. et al. Predictive utility of cardiovascular risk prediction algorithms in inflammatory rheumatic diseases: a systematic review // J. Rheumatol. 2020. Vol. 47, No. 6. P. 928–938. DOI: 10.3899/jrheum.190261

[47] Gerasimova EV, Popkova TV, Gerasimova DA, et al. Application of cardiovascular risk scales to identify carotid atherosclerosis in patients with rheumatoid arthritis. Terapevticheskii Arkhiv. 2021;93(5):561–567. (In Russ.) DOI: 10.26442/00403660.2021.05.200787

[48] Герасимова Е.В., Попкова Т.В., Герасимова Д.А. и др. Применение шкал сердечно-сосудистого риска для идентификации атеросклероза сонных артерий у больных ревматоидным артритом // Терапевтический архив. 2021. Т. 93, № 5. С. 561–567. DOI: 10.26442/00403660.2021.05.200787

[49] Błyszczuk P, Szekanecz Z. Pathogenesis of ischaemic and non-ischaemic heart diseases in rheumatoid arthritis. RMD Open. 2020;6(1):e001032. DOI: 10.1136/rmdopen-2019-001032

[50] Błyszczuk P., Szekanecz Z. Pathogenesis of ischaemic and non-ischaemic heart diseases in rheumatoid arthritis // RMD Open. 2020. Vol. 6, No. 1. P. e001032. DOI: 10.1136/rmdopen-2019-001032

[51] England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ. 2018;361:k1036. DOI: 10.1136/bmj.k1036

[52] England B.R., Thiele G.M., Anderson D.R., Mikuls T.R. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications // BMJ. 2018. Vol. 361. P. k1036. DOI: 10.1136/bmj.k1036

[53] Machlus KR, Thon JN, Italiano JE Jr. Interpreting the developmental dance of the megakaryocyte: a review of the cellular and molecular processes mediating platelet formation. Br J Haematol. 2014;165(2):227–236. DOI: 10.1111/bjh.12758

[54] Machlus K.R., Thon J.N., Italiano J.E. Jr. Interpreting the developmental dance of the megakaryocyte: a review of the cellular and molecular processes mediating platelet formation // Br. J. Haematol. 2014. Vol. 165, No. 2. P. 227–236. DOI: 10.1111/bjh.12758

[55] Garraud O, Cognasse F. Are platelets cells? And if yes, are they immune cells? Front Immunol. 2015;6:70. DOI: 10.3389/fimmu.2015.00070

[56] Garraud O., Cognasse F. Are platelets cells? And if yes, are they immune cells? // Front. Immunol. 2015. Vol. 6. P. 70. DOI: 10.3389/fimmu.2015.00070

[57] Amaya-Amaya J, Montoya-Sanchez L, Rojas-Villarraga A. Cardiovascular involvement in autoimmune diseases. Biomed Res Int. 2014;2014:367359. DOI: 10.1155/2014/367359

[58] Amaya-Amaya J., Montoya-Sanchez L., Rojas-Villarraga A. Cardiovascular involvement in autoimmune diseases // Biomed. Res. Int. 2014. Vol. 2014. P. 367359. DOI: 10.1155/2014/367359

[59] Golebiewska EM, Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 2015;29(3):153–162. DOI: 10.1016/j.blre.2014.10.003

[60] Golebiewska E.M., Poole A.W. Platelet secretion: From haemostasis to wound healing and beyond // Blood Rev. 2015. Vol. 29, No. 3. P. 153–162. DOI: 10.1016/j.blre.2014.10.003

[61] Mazurov VI, Melnikov ЕS, Bashkinov RA. Effect of platelets on the course of rheumatoid arthritis and cardiovascular risk. Terapiya. 2021;7(10(52)):78–88. (In Russ.) DOI: 10.18565/therapy.2021.10.78-88

[62] Мазуров В.И., Мельников Е.С., Башкинов Р.А. Влияние тромбоцитов на течение ревматоидного артрита и сердечно-сосудистый риск // Терапия. 2021. Т. 7, № 10(52). С. 78–88. DOI: 10.18565/therapy.2021.10.78-88

RIGHTS & PERMISSIONS

Eco-Vector