Background RA is a proatherogenic diseases, but detection of patients with moderate/high risk cardiovascular event has some differences with the general population.
Objectives To determine the correlation between Coronary Artery Calcification Score (CACS), carotid intima-media thickness (cIMT), lipid profile and coronary risk evaluation by SCORE and mSCORE in detecting subclinical atherosclerosis in rheumatoid arthritis (RA) patients.
Methods A set of 87 consecutive RA patients in the mean age 45,2±1,56 without history of cardiovascular (CV) events were studied to determine relationship between CACS, cIMT and carotid plaques (CP) and lipid profile. The mean disease duration was 7.9±0.7 years, 84,7% had rheumatoid factor and/or anti-CCP positivity and 33,8% extra-articular manifestations. 84.8% patients received biologic therapy more than one year. All subjects underwent CT imaging of coronary arteries using a 16-slice multi-detector computed tomography (MDCT) scanner (Lightspeed, 16, GE Healthcare, USA). Carotid ultrasonography examination included the measurement of cIMT in the common carotid artery, detection of focal plaques in the extracranial carotid tree, blood flow velocity and morphology of the intima. 40 healthy women in the mean age 32,8±1,56 was undergo carotid ultrasound by the same parameters.
Results RA patients were stratified according to the cIMT and CPs. A cIMT>0.90 mm was observed in 23 (26.4%) and CP in 25 (28.7%) patients. 57.7% of the patients with cIMT>0.90 had unilateral and 30.8% bilateral CP, 7 (30.4%) categorized as having low, 10 (43.5%) moderate and 6 (26%) high CV risk. Only 1 patient has CACS ≥1, 6 patients had calcinosis of aorta and valves. The CPs was observed only in patients at age 50 and older. The patients with cIMT>0.90 mm and CPs was significantly older (56.2±2.4 vs 40.53±1.6 years), but had no differences in diseases duration and level of total cholesterol. 67% of patients had fragmentation, induration and interruption of the layers differentiation of the intima. Any changes of the intima morphology in healthy women was observed.
Conclusions The use of CACS does not allow identifying properly high/very high CV risk RA patients. Patient with cIMT>0.90 mm had significantly high level of CRP, LDL cholesterol and TG in mouse macrophages. 67% of patients had abnormal of intima morphology by carotid ultrasound in comparison with control group.
Disclosure of Interest None declared