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 (R) 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 (R) 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 (R) 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.