Background: anti-inflammatory therapy supposed to influence the rate of cardiovascular events development in pts with calcium pyrophosphate deposition disease (CPPD).

Objectives: To assess the effect of colchicine, hydroxychloroquine, and methotrexate on cardiovascular outcomes (CVO) in CPPD pts.

Methods: The study included 305 pts with CPPD: 115 (37.70%) men, 190 (62.30%) women. The average follow-up period was 3.9±2.7 yrs. Among the factors influencing CVO were considered: gender, age, smoking, alcohol intake ≥20 standard doses/week, hypertension, history of cardiovascular disease (CVD): (ischemic heart disease (CHD), acute myocardial infarction myocardial infarction (AMI), acute cerebrovascular insufficiency (ACV), chronic heart failure (CHF) >3 grade, NYHA), diabetes mellitus (DM), BMI >25 kg/m ² and >30 kg/m ² , cholesterol level >5.1 mmol/l, GFR <60 ml/min/1.73 m ² , serim uric acid (sUA) > 360 µmol/l, hypercalcemia (serum calcium> 2.62 mmol/l), CRP> 2 mg/l, hyperparathyroidism (parathyroid hormone> 65 pg/ml), phenotypes of CPPD (asymptomatic, osteoarthritis with calcium pyrophosphate crystals (OA with CPP crystals), chronic arthritis, acute arthritis), taking colchicine, hydroxychloroquine and methotrexate, glucocorticoids (GCs) and non-steroidal anti-inflammatory drugs (NSAIDs).

Information about mortality, regardless of cause, was noting down throughout the follow-up period.

The causes of death were determined on the patient’s death certificate, and then classified according to the International Classification of Diseases of the 10-th Revision (ICD-10) All newly developed cases of non-fatal cardiovascular events were identified on the basis of medical documentation. The odds ratio (OR) with a 95% confidence interval of developing cardiovascular events was calculated. Statistica 12.0 package was used for statistical data processing.

Results: The mean age at inclusion was 58.9±12.5 yrs. 264 patients were available for follow-up. Any of the studied cardiovascular events were registered in 79 (29.9%) pts. During the follow-up period, 46 (17.4%) pts died; 35 of 46 (76.1%) pts died because of CVD; 11 (23.9%) pts died due to other causes. Non-fatal cardiovascular events were registered in 44 (16.7%) pts.

The risk of cardiovascular events was higher for ps aged >65 years (OR 5.97, 95% CI 3.33-10.71), serum cholesterol level ≥5.1 mmol/l (OR 1.95, 95% CI 1.04-3.65]), GFR <60 ml/min/1.73 m ² (OR 2.78, 95% CI 1.32-5.56]), history of CVD (OR 2.32, 95% CI 1.22-4.44) Colchicine therapy was associated with the lower risk of cardiovascular events (OR 0.20, 95% CI 0.11-0.39]). Therapy with methorexate and hydroxychloroquine did not exert an influence on opportunity of CVO.

Conclusion: Adverse CVD outcomes in CPPD pts are associated with age, hypercholesterolemia, CKD, and a history of CVD. The intake of colchicine, but not methotrexate and hydroxychloroquine, by patients with CPPD is associated with decline of risk of cardiovascular events.

REFERENCES:

[1]Bashir M, Sherman KA, Solomon DH, et al. Cardiovascular disease risk in calcium pyrophosphate deposition disease: A nationwide study of veterans. Arthritis Care Res (Hoboken). 2021 Sep 14. doi: 10.1002/acr.24783.

Disclosure of Interests: Elena Cheremushkina: None declared, Maxim Eliseev Speakers bureau: Berlin Chemie Menarini Group, Sobi, EGIS, CSC, MosFarma, Alium Group, Olga Sheliabina Speakers bureau: Berlin Chemie Menarini Group, Aleksandra Novikova: None declared, Svetlana Glukhova: None declared