Evaluation of Cardiovascular risk in Egyptian rheumatoid arthritis patients using carotid ultrasound and Coronary Artery Calcification Score to detect subclinical atherosclerosis.

Objective To assess the presence of subclinical atherosclerosis in patients with rheumatoid arthritis (RA ) without clinically evident atherosclerosis or its complications and to determine the ability of Coronary Artery Calcification Score (CACS) and carotid ultrasonography in detecting subclinical atherosclerosis in rheumatoid arthritis (RA). Methods A Case control study which included 100 patients with RA having disease duration more than 5 years and 50 healthy age and sex and BMI matched controls. Cases and controls symptomatic for atherosclerosis or having traditional risk factors for atherosclerosis were excluded. Both cases and controls were subjected to carotid ultrasound and CT imaging of coronary arteries. CV risk was calculated according to the Framingham risk score. Results: CIMT in RA patients was significantly greater than that in controls (0.87 ± 0.09 mm mm versus 0.58±0.14 mm; mm; P < 0.001). RA patients was significantly greater in the presence of carotid plaque and coronary artery calcifications than that in controls . RA patients had higher Framingham risk score than control . CV risk was categorized in the RA patients according to the Framingham risk score mild ( 64%), moderate and high risk(36%) Conclusions: Patients with RA exhibit premature atherosclerosis by way of increased CIMT and carotid plaques when compared to age and sex matched controls . RA patients had higher Framingham risk score than control.