Application of cardiovascular risk scales to identify carotid atherosclerosis in patients with rheumatoid arthritis

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Abstract

Aim. To evaluate the cardiovascular risk (CVR) and analyze its relationship with detection of early carotid artery atherosclerotic lesion in patients with rheumatoid arthritis (RA).

Materials and methods. One hundred and nine RA patients aged 45 to 60 without established cardiovascular diseases (CVD) were included in the study. The median age was 52 [48; 54] years, duration of RA was 120 [36; 204] months, DAS28 was 4.7 [3.5; 5.6] points. CVD risk was calculated with mSCORE, Reynolds Risk Score (RRS), ASSIGN, QRISK3, ERS-RA scales and Carotid Artery Doppler Ultrasound Exam was performed for all patients.

Results. High risk was found in 5, 5, 14, 6, and 38% of patients according to mSCORE, RRS, ASSIGN, QRISK3, ERS-RA scales, respectively. Atherosclerotic plaques of carotid arteries were found in 30% of patients. It was found that carotid intima-media thickness is correlated to all CVR calculators, age, systolic and diastolic blood pressure, cholesterol, erythrocyte sedimentation rate, interleukin-6 levels. The sensitivity and specificity of the CVR algorithms in prognostication of atherosclerotic carotid artery lesions were 73 and 67% for mSCORE, 64 and 63% for RRS, 64 and 56% for ASSIGN, 73 and 49% for QRISK3, respectively, p<0.05 in all cases, 67 and 50% for ERS-RA, p=0.06.

Conclusion. RRS, mSCORE, ASSIGN, QRISK3 calculators equally predict atherosclerotic carotid artery damage in RA patients. The optimal ratio of specificity and sensitivity is shown for the mSCORE scale. Stratification of CVR in RA patients should include assessment of the carotid intima-media thickness. To identify CVR in RA patients, the most informative methods are mSCORE calculation and carotid intima-media thickness determination.

About the authors

Elena V. Gerasimova

Nasonova Research Institute of Rheumatology

Author for correspondence.
Email: gerasimovaev@list.ru
ORCID iD: 0000-0001-5815-561X

канд. мед. наук, ст. науч. сотр. лаб. системных ревматических заболеваний

Russian Federation, Moscow

Tatiana V. Popkova

Nasonova Research Institute of Rheumatology

Email: gerasimovaev@list.ru
ORCID iD: 0000-0001-5793-4689

д-р мед. наук, зав. лаб. системных ревматических заболеваний

Russian Federation, Moscow

Daria A. Gerasimova

Sechenov First Moscow State Medical University (Sechenov University)

Email: gerasimovaev@list.ru
ORCID iD: 0000-0002-4958-0400

мл. науч. сотр. фак-та фарм-экономики

Russian Federation, Moscow

Svetlana I. Glukhova

Nasonova Research Institute of Rheumatology

Email: gerasimovaev@list.ru
ORCID iD: 0000-0002-4285-0869

канд. физ.-мат. наук, ст. науч. сотр. лаб. медико-социальных проблем ревматологии

Russian Federation, Moscow

Evgeny L. Nasonov

Nasonova Research Institute of Rheumatology; Sechenov First Moscow State Medical University (Sechenov University)

Email: nasonov@irramn.ru
ORCID iD: 0000-0002-1598-8360

акад. РАН, д-р мед. наук, проф., науч. рук. ФГБНУ «НИИ ревматологии ревматологии им. В.А. Насоновой», проф. ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» 

Russian Federation, Moscow; Moscow

Aleksander M. Lila

Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education

Email: gerasimovaev@list.ru

д-р мед. наук, проф., дир. ФГБНУ «НИИР им. В.А. Насоновой», зав. каф. ревматологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. Frequency of conventional RF in RA patients.

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3. Fig. 2. ROC curves of mSCORE, RRS, ASSIGN, QRISK3, ERS-RA calculators.

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