Silvia Rollefstad

Diakonhjemmet Hospital (Norway) · Department of Rheumatology

Objective To describe the prevalence of atrial fibrillation (AF) in patients with rheumatoid arthritis (RA), and to evaluate the proportion of patients with AF receiving guideline-recommended anticoagulation for prevention of stroke, based on data from a large international audit. Methods The cohort was derived from the international audit SUrvey...

Background Gout is of unknown reason associated with cardiovascular disease. Ultrasound is sensitive for detecting crystal deposition and plasma calprotectin is a sensitive inflammatory marker. This study explores the associations between crystal deposition, inflammation and carotid artery pathology. Method A cross-sectional analysis of baseline a...

Objectives: To explore mortality and causes of death among Norwegian patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) compared with the general population by conducting a nationwide registry-based cohort study. Methods: Patients with RA, PsA and axSpA were identified from the Norwegian Patien...

Background and aims: Rheumatoid arthritis (RA) patients are at a high risk of atherosclerotic cardiovascular disease (ASCVD). This implies a need for meticulous CVD risk factor recording and control. Objectives: The aim was to evaluate the international prevalence of ASCVD in RA patients and to audit the prevalence and control of CVD risk factors....

Objectives : To evaluate nationwide incidence, sociodemographic associations and treatment penetration of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in Norway. Methods : The study combined data from nationwide registries on the total Norwegian adult population (age ≥18). From the Norwegian Patient Registry, incident RA and PsA cases d...

Aims: To assess differences in estimated cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients from different world regions. Further to evaluate the management and goal attainment of lipids and blood pressure (BP). Methods and results: The SUrvey of CVD Risk Factors in patients with RA was conducted in 14503 patients from 19...

Aim The objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention....

Patients with rheumatoid arthritis (RA) are at approximately 1.5-fold risk of atherosclerotic cardiovascular disease (CVD) compared with the general population, a phenomenon resulting from combined effects of traditional CVD risk factors and systemic inflammation. Rheumatoid synovitis and unstable atherosclerotic plaques share common inflammatory m...

Patients with rheumatoid arthritis (RA) are at high risk of developing cardiovascular disease (CVD). Inflammation has a pivotal role in the pathogenesis of CVD. RA is an inflammatory joint disease and, compared with the general population, patients with RA have approximately double the risk of atherosclerotic CVD, stroke, heart failure and atrial f...

Objective: Statin treatment has been associated with reduction in blood pressure and arterial stiffness in patients with inflammatory joint diseases (IJD). We tested whether statin treatment also was associated with regression of preclinical cardiac organ damage in IJD patients. Methods: Echocardiography was performed in 84 IJD patients (52 RA,...

Background: In younger individuals, low absolute risk of cardiovascular disease (CVD) may conceal an increased risk age and relative risk of CVD. Calculation of risk age is proposed as an adjuvant to absolute CVD risk estimation in European guidelines. We aimed to compare the discriminative ability of available risk age models in prediction of CVD...

The aim was to study the different strategies used to implement cardiovascular risk evaluation and management for patients with rheumatoid arthritis (RA) in daily clinical practice. A questionnaire survey was performed among both the members of the international Trans-Atlantic Cardiovascular Risk Consortium for Rheumatoid Arthritis (ATACC-RA) as we...

Background: The effect of statins over time on coronary atherosclerosis in patients with inflammatory joint diseases (IJD) is unknown. Our aim was to evaluate the change in coronary plaque morphology and volume in long-term statin-treated patients with IJD. Methods: Sixty-eight patients with IJD and carotid artery plaque(s) underwent coronary co...

Objectives: Smoking is a major risk factor for the development of both cardiovascular disease (CVD) and RA and may cause attenuated responses to anti-rheumatic treatments. Our aim was to compare disease activity, CVD risk factors and CVD event rates across smoking status in RA patients. Methods: Disease characteristics, CVD risk factors and rele...

Background: Chronic inflammatory joint diseases (IJDs) affect 1% to 2% of the population in developed countries. IJDs include rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and other forms of spondyloarthritis (SpA). Tobacco smoking is considered a significant environmental risk factor for developing IJDs. There...

Background The association between gout and cardiovascular disease (CVD) is well known,¹ whereas mechanisms behind this association are poorly understood. Objectives This study aimed to evaluate factors associated with asymptomatic carotid atherosclerosis in patients with gout. Methods In this prospective study patients with crystal-proven gout w...

Background Smoking is a major risk factor for development of both cardiovascular disease (CVD) and rheumatoid arthritis (RA) and causes an attenuated response to antirheumatic treatment. Objectives The aim of this study was to compare disease activity and CVD risk factors across smoking status in RA patients. Further to evaluate the impact of smok...

Background Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown. Objective To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA). Method Assessor blinded multicent...

Objective The European League Against Rheumatism recommends implementing cardiovascular disease (CVD) risk assessments for patients with inflammatory joint diseases (IJDs) into clinical practice. Our goal was to design a structured programme for CVD risk assessments to be implemented into routine rheumatology outpatient clinic visits. Methods The...

Objective Subclinical left ventricular (LV) myocardial dysfunction is associated with increased risk of cardiovascular disease (CVD), but it is not known if subclinical LV myocardial dysfunction is present in patients with ankylosing spondylitis (AS) independent of CVD risk factors. Methods Conventional and speckle tracking echocardiography was pe...

Background Patients with inflammatory joint diseases (IJD) have an increased risk of cardiovascular disease (CVD) compared to the general population. Nutritional advice has been shown to influence CVD risk factors. Our objective was to evaluate whether an individually tailored dietary counselling versus a brief standardised advice on heart-friendly...

Objectives: Patients with inflammatory joint diseases (IJD) have an increased risk of cardiovascular disease (CVD). Our goal was to examine indications for, and use of, lipid-lowering therapy (LLT) and antihypertensive treatment (AntiHT) in patients with IJD. Furthermore, to investigate the frequency of low-density lipoprotein cholesterol (LDL-c)...

Objective: Ankylosing spondylitis (AS) is associated with increased risk for cardiovascular disease (CVD). Left ventricular (LV) hypertrophy is a strong precursor for clinical CVD. The aim of our study was to assess whether having AS was associated with increased prevalence of LV hypertrophy. Methods: Clinical and echocardiographic data from 139...

Patients with psoriatic arthritis and other inflammatory joint diseases have a high risk of cardiovascular disease (CVD), but use relatively little preventive medication such as antihypertensive and lipid lowering agents. An unmet need exists for the optimization of CVD prevention in this high-risk patient population.

Objectives The aim of this population-based study was to compare changes in cardiovascular (CV) risk factors over a decade-long period in patients who developed psoriatic arthritis (PsA) and the background population. Methods Patients diagnosed with PsA (n=151) between 1998 and 2008 and matched controls (n=755) who participated in both the Nord-Tr...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To investigate the evidence for an effect of smoking cessation interventions on smoking cessation and disease activity in smokers with IJD.

Objective Low association between cardiac symptoms and coronary artery disease (CAD) in patients with inflammatory joint diseases (IJD) demands for objective markers to improve cardiovascular risk stratification. Our main aim was to evaluate the prevalence and characteristics of CAD in patients with IJD with carotid artery plaques. Furthermore, we...

Background Patients with inflammatory joint diseases (IJD) have increased risk of cardiovascular disease (CVD). Our aim was to compare CVD risk profiles in patients with IJD, including rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) and evaluate the future risk of CVD. Methods The prevalence and numbers of...

Objective Cardiovascular disease (CVD) risk calculators designed for use in the general population do not accurately predict the risk of CVD among patients with rheumatoid arthritis (RA), who are at increased risk of CVD. The process of developing risk prediction models involves numerous issues. Our goal was to develop a CVD risk calculator for pat...

Although there is a large body of knowledge on the increased cardiovascular disease (CVD) risk in rheumatoid arthritis (RA), there is a lack of clinical evidence on management of the increased risk.

Cardiovascular disease (CVD) is the major cause of death in the general population, but there has been a large reduction in both mortality and morbidity of CVD since the 1970s. Although patients with rheumatoid arthritis (RA) have an increased risk of CVD, and a mortality gap between RA patients and the general population has been described, it is...

Several studies have shown that the cardiovascular disease (CVD) risk in patients with rheumatoid arthritis (RA) is underestimated.

Background: The association of hypertension with asymptomatic cardiovascular organ damage in patients with rheumatoid arthritis (RA) has been little studied by echocardiography. Methods: Echocardiography was done in 134 RA patients and 102 healthy controls. Left ventricular (LV) geometry was considered abnormal if LV mass index or relative wall...

Objective: Patients with inflammatory joint diseases (IJD) have a high prevalence of hypertension and increased arterial stiffness. The aim of the present study was to evaluate the effect of long-term rosuvastatin treatment on arterial stiffness, measured by augmentation index (AIx) and aortic pulse wave velocity (aPWV), and blood pressure (BP) in...

The ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) Study Protocol in English. (PDF)

The ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) Study Protocol in original language (Norwegian). (PDF)

The Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist for the RORA-AS study. (PDF)

Evaluation for variables correlated with change in the dependent variables augmentation index (ΔAIx), aortic pulse wave velocity (ΔaPWV), systolic (ΔsBP) and diastolic (ΔdBP) blood pressure. Δ: Change from baseline to study end, AIx: Augmentation index, aPWV: aortic pulse wave velocity, sBP: systolic blood pressure, dBP: diastolic BP, BMI: Body mas...

Change in augmentation index (AIx), aortic pulse wave velocity (aPWV), systolic (sBP) and diastolic (dBP) blood pressure after 18 months rosuvastatin therapy. RA: Rheumatoid arthritis, AS: Ankylosing spondylitis, PsA: Psoriatic arthritis, Paired samples t-test by diagnose. (DOCX)

Evaluation for predictors of change in the dependent variables augmentation index (ΔAIx), aortic pulse wave velocity (ΔaPWV), systolic (ΔsBP) and diastolic (ΔdBP) blood pressure. Δ: Change from baseline to study end, aPWV: aortic pulse wave velocity, AIx: Augmentation index, sBP: Systolic blood pressure, dBP: Diastolic blood pressure, bMARDs: Biolo...

Objectives: The relation between chest pain and coronary atherosclerosis (CA) in patients with inflammatory joint diseases (IJD) has not been explored previously. Our aim was to evaluate the associations of the presence of chest pain and the predicted 10-year risk of cardiovascular disease (CVD) by use of several CVD risk algorithms, with CA verif...

Introduction: Endothelial dysfunction is an early step in the atherosclerotic process and can be quantified by flow-mediated vasodilation (FMD). Our aim was to investigate the effect of long-term rosuvastatin therapy on endothelial function in patients with inflammatory joint diseases (IJD) with established atherosclerosis. Furthermore, to evaluat...

Objective: Patients with rheumatoid arthritis (RA) and carotid artery plaques have an increased risk of acute coronary syndromes. Statin treatment with the goal of achieving a low-density lipoprotein (LDL) cholesterol level of ≤1.8 mmoles/liter (≤70 mg/dl) is recommended for individuals in the general population who have carotid plaques. The aim o...

To compare the presence of cardiovascular (CV) risk factors and established CV disease in patients with psoriatic arthritis (PsA) and the general population and to compare the 10-year risk of a fatal CV event calculated by the Systematic Coronary Risk Evaluation (SCORE) algorithm. Patients with PsA (n=338) and controls (n=50 468) were recruited fro...

Objective: EULAR recommendations for cardiovascular disease (CVD) risk management include annual CVD risk assessments for patients with rheumatoid arthritis (RA). We evaluated the recording of CVD risk factors (CVD-RF) in a rheumatology outpatient clinic, where EULAR recommendations had been implemented. Further, we compared CVD-RF recordings betw...

Predictive performance of cardiovascular disease (CVD) risk calculators appears suboptimal in rheumatoid arthritis (RA). A disease-specific CVD risk algorithm may improve CVD risk prediction in RA. The objectives of this study are to adapt the Systematic COronary Risk Evaluation (SCORE) algorithm with determinants of CVD risk in RA and to assess th...

There is a lipid paradox in rheumatoid arthritis describing that despite low lipids related to systemic inflammation, there is an increased cardiovascular (CV) risk. Our aim was to evaluate if baseline lipid levels or baseline systemic inflammation were associated with the statin dose sufficient to achieve lipid targets in patients with inflammator...

As physicians we like to have evidence for making decisions about interventions to improve health. The evidence vacuum in the field of cardiovascular disease (CVD) prevention and clinical outcome in patients with rheumatoid arthritis (RA) has received vigorous attention in the recent literature. There is broad agreement that a patient with RA fulfi...

Knowledge about the prevalence and consequences of osteoarthritis (OA) in the Norwegian population is limited. This study has been designed to gain a greater understanding of musculoskeletal pain in the general population with a focus on clinically and radiologically confirmed OA, as well as risk factors, consequences, and management of OA. The Mus...

Background: Patients with asymptomatic carotid plaque (a-CP) should receive intensive lipid lowering (LL) treatment in cardiovascular (CV) prevention. We evaluated if CV risk calculators predict the presence of a-CP in patients with inlammatory joint disease (IJD) and if optimizing cut off points in risk calculators will improve this prediction.

Objective: Carotid plaques (CP) are predictive of acute coronary syndrome in patients with rheumatoid arthritis (RA), suggesting that atherosclerotic plaques in these patients are vulnerable. The objective of our study was to characterize vulnerability of CP in patients with RA compared to a control population, and between RA patients with differe...

Objectives: To perform cardiovascular risk stratification in patients with inflammatory joint diseases (IJD) and treat to lipid targets according to recommendations. Methods: We initiated a preventive cardio-rheuma clinic based on the unmet need of adequate cardiovascular prevention in IJD patients. A full cardiovascular risk stratification was...