Subclinical Atherosclerotic Disease in Patients with Rheumatoid Arthritis
Keywords:
atherosclerosis, risk factors, cardiovascular disease.Abstract
Introduction: In patients with rheumatoid arthritis there is an increased morbidity and mortality due to atherosclerotic cardiovascular disease.
Objective: To determine the prevalence of subclinical atherosclerotic disease in patients with rheumatoid arthritis and to identify independently associated factors.
Methods: A cross-sectional study was conducted in 110 patients with a diagnosis of rheumatoid arthritis seen at the International Health Center "La Pradera" in the period from January 2010 to December 2018. The frequency of subclinical atherosclerotic disease was determined, evaluated with carotid Doppler ultrasound. Variables such as time of evolution and disease activity, erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor were also considered.
Results: Female patients predominated. The median age of the patients was 41 years. The average time of disease evolution was 8 years. Smoking was the most frequent risk factor in these cases (23.6%), as were arterial hypertension and diabetes mellitus. The prevalence of subclinical atherosclerotic disease was 53.5%. The existence of positive rheumatoid factor was independently associated with the presence of subclinical atherosclerotic disease in patients with rheumatoid arthritis, as was active disease (DAS28 > 2.6) and the coexistence of HDLc > 1.38 mmol/L in those patients with negative rheumatoid factor.
Conclusions: The marked presence of subclinical atherosclerotic disease in patients with rheumatoid arthritis was associated with markers of inflammation.
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