APPLICATION OF PREVENTIVE CV RISK STRATEGIES FOR DYSLIPIDEMIA IN RHEUMATOID ARTHRITIS PATIENTS: DATA FROM THE CARDIOVASCULAR OBESITY AND RHEUMATIC DISEASES (CORDIS) STUDY GROUP OF THE ITALIAN SOCIETY OF RHEUMATOLOGY

F. Cacciapaglia, M. Piga, G. L. Erre, G. Sakellariou, A. Manfredi, O. Viapiana, E. Gremese, F. R. Spinelli, F. Atzeni, E. BartoloniUniversity and AOU, Policlinico of Bari., Department of Precision and Regenerative Medicine and Ionian Area, Bari, Italy Rheumatology Unit., Department of Medical Sciences and Public Health, AOU and University of Cagliari, Cagliari, Italy University and AOU of Sassari., Dipartimento di Medicina, Chirurgia e Farmacia, Sassari, Italy University of Pavia, Istituti Clinici Scientifici Maugeri IRCCS Pavia, Pavia, Italy Unit of Rheumatology, Azienda Ospedaliera Universitaria Policlinico di Modena., Modena, Italy University of Verona, Department of Medicine, Verona, Italy Policlinico Gemelli, Università Cattolica del Sacro Cuore, Dipartimento di Scienze Mediche e Chirurgiche, Roma, Italy Università La Sapienza, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Roma, Italy Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina., Messina, Italy Rheumatology Unit. University of Perugia., Department of Medicine and Surgery, Perugia, Italy  Background Rheumatoid arthritis (RA) patients are at high risk for atherosclerotic cardiovascular disease (CVD) and mortality, and dyslipidemia represents a modifiable CV risk factor significantly contributing to the increased risk. However, dyslipidemia is frequently underestimated and inadequately managed in rheumatologic clinical practice. Objectives The aim of the present study was to investigate how dyslipidemia in RA patients is managed in a real-life setting for primary prevention strategies. Methods A cross-sectional study of RA patients of the Cardiovascular Obesity and Rheumatic DISeases (CORDIS) cohort [1], with no previous CVD and with available lipid levels was performed. All patients were stratified by the Systematic COronary Risk Evaluation (SCORE) algorithm for CV risk [2] and the application of primary preventive strategy was assessed in accordance with the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for the management of dyslipidaemias [3]. Results A total of 1296 RA patients (79% females) with a mean age of 59±12 years were included. According to the SCORE algorithm, 457 (35.5%) patients were at moderate CV risk (1-5%), 455 (35.1%) at high CV risk (5-10%), and 384 (29.6%) at very high (>10%) CV risk. None was at low CV risk (<1%). Eighty percent of the whole cohort was eligible for statin therapy, but only 22.3% was on treatment at inclusion, and 38.2% presented lipid levels on target. Among patients at high and/or very-high SCORE risk, 70% were not on statin treatment even if recommended and 26.7% were not at lipid target even if under statin use. Among patients at moderate SCORE risk, 208 (45.5%) were at lipid target and 31(14.9%) of them were on statin therapy. Globally 565 (43.6%) patients were not on treatment for dyslipidemia even if recommended according to ESC/EAS guidelines (Figure 1). Of note, about 80% of RA patients at high or very high CV risk were on anti-hypertensive and/or antiaggregant treatment. Conclusion Statin therapy prescription is suboptimal in RA despite a relevant proportion of patients meeting indications according to LDL thresholds and/or SCORE algorithm. Preventive CV strategies seem mainly focused on anti-hypertensive or antiplatelet therapy. Rheumatologists should pay close attention to lipid levels and preventive therapeutic interventions to reduce the CV risk of RA patients. References Eur J Intern Med. 2022 Feb;96:60-65. doi:10.1016/j.ejim.2021.10.001. Eur J Prev Cardiol. 2016 Jul;23(11):NP1-NP96. doi:10.1177/2047487316653709. Eur Heart Journal, 2020 Jan;41(1):111-188. doi.org/10.1093/eurheartj/ehz455. Figure 1. Image/graph: Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: Rheumatoid arthritis, Cardiovascular disease DOI: 10.1136/annrheumdis-2023-eular.1760Citation: , volume 82, supplement 1, year 2023, page 17Session: Comorbidities in RMD (Oral Presentations)