Cardiovascular risk assessment in female patients with rheumatoid arthritis

Background

Rheumatoid arthritis (RA) is one of the most common rheumatological disorders, that not only affect the synovial joints, but also, it has several extra-articular complications related to heart, and other organs.

Aim of the work:

To assess the cardiovascular risk in RA female patients.

Patients and methods:

60 RA female patients, were subjected to full medical history, clinical examination, laboratory assessment, disease activity score (DAS-28), ultrasonography on both common carotid and common femoral arteries, and cardiovascular risk score (QRISK®3).

Results:

The patients age was 48.4 ± 7.2 years (40–70 years), median disease duration of 7 years and 20 (33.3 %) were passive smokers. Disease activity was 4.6 ± 1.47 (1.5–7.8).Duration of steroid, methotrexate (MTX) and hydroxychloroquine (HCQ) 1–240 months, leflunomide 6–240 months, sulphasalazine 3–156 months and baricitinib 0–9 months. QRISK®3 was significantly correlated with age (p < 0.001), total cholesterol (p = 0.017), right and left carotid and right femoral intima media thickness (IMT) (p = 0.027, p = 0.006, and p = 0.009 respectively). Regarding the IMT, a significant correlation was found with age in all territories (bilateral carotid and bilateral femoral arteries), where anti CCP and QRISK®3 was correlated with the right carotid IMT (p = 0.039, and p = 0.027 respectively), While the duration of using baricitinib was negatively correlated and significant with right carotid (r = -0.285,p = 0.027).Regressions analysis of right carotid was significant with age, left carotid with CRP and right femoral with Q risk.

Conclusion:

RA patients have multiple risk factors that increase cardiovascular events. Age, Anti cyclic citrullinated peptide (Anti-CCP) levels, MTX, HCQ, and leflunomide may aggravate atherosclerosis, while baricitinib may be a protective factor.