Background Cardiovascular (CV) disease is a leading cause of morbidity and mortality in patients with rheumatoid arthritis (RA).
Objectives The aim of this study is to assess the 10-year CV risk using three different CV risk score calculators in RA patients, and to investigate the correlation between the calculated risk and subclinical atherosclerosis.
Methods A total of 147 consecutive patients with RA underwent the carotid ultrasound to measure the carotid intra media thickness (IMT). The estimated 10-year CV risk by the systematic coronary risk evaluation (SCORE) model, the Framingham risk score (FRS), and the atherosclerotic CV disease (ASCVD) risk estimator, was modified according to the EULAR guideline. The association of modified CV risk with the carotid IMT was analysed.
Results The carotid ultrasound revealed 0.74 mm of mean common carotid artery (CCA) IMT and 44.9% of carotid plaques in the study population. The median of the modified 10-year CV risk evaluated by SCORE, FRS, and ASCVD was 1.5 (Interquartile range [IQR] 0-3), 6.9 (IQR 3.1-11.5), and 3.4 (IQR 1.1-7.8), respectively. When classified by the criteria of the CV risk calculators, 9 (6.1%), 11 (7.5%), and 36 (24.5%) of RA patients were included in the higher risk groups of the respective risk estimators. Patients in high risk groups had significantly greater mean CCA IMT with more frequent carotid plaques, compared to patients in lower risk groups, regardless of the CV risk calculators. The modified CV risk estimated using three different models was clearly correlated with the mean CCA IMT.
Conclusions The estimated 10-year CV risk was well correlated with the morphological evidence of subclinical atherosclerosis. This study indicates that the assessment of the CV risk using the risk score calculators would be useful in clinical practice for management of RA.
Peters, M.J., 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): p. 325-31.
Park, Y.B., et al., Atherosclerosis in rheumatoid arthritis: morphologic evidence obtained by carotid ultrasound. Arthritis Rheum, 2002. 46(7): p. 1714-9.
Acknowledgements This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI10C2020).
Disclosure of Interest None declared
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