Cardiovascular Risk in Patients with Rheumatoid Arthritis Assessed by Carotid and Femoral Ultrasound

Abstract

Introduction: Rheumatoid arthritis (RA) is associated with chronic systemic inflammation, which increases the risk of cardiovascular disease (CVD). Traditional risk scores, such as Framingham, underestimate this risk in RA patients. Carotid and femoral ultrasound (US) allows non-invasive evaluation of subclinical atherosclerosis. Objective: To assess cardiovascular risk (CVR) using carotid and femoral ultrasound in patients with RA.

Methods: A cross-sectional descriptive study was conducted, including 90 patients (60 seropositive and 30 seronegative, aged 30 to 74 years, with ≥5 years of disease duration. Patients with established CVD or recent statin use were excluded. CVR was assessed using the EULAR-modified SCORE. Carotid and femoral intima-media thickness (IMT) was evaluated using US. Non-parametric statistical analyses were performed with a significance level of p < 0.05.

Results: The overall prevalence of subclinical atherosclerosis was 7.8%. The RA seropositive group presented moderate (73.3%), high (18.3%), and very high (8.3%) CVR; 95% had Grade I (low risk) and 5% Grade II (intermediate risk) according to US. The RA seronegative group showed moderate (76.7%), high (13.3%), and very high (10%) CVR; 94.4% had low risk, and 5.6% had intermediate risk based on US.

Conclusions: Subclinical atherosclerosis is more prevalent in seropositive RA patients, with greater intimamedia thickness in femoral arteries. Carotid ultrasound is a valuable tool for early CVR detection.