1. Cardiovascular Risk Assessment in Women With Rheumatoid Arthritis Through Carotid and Femoral Artery Doppler Ultrasound
- Author
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Rina Dalva Neubarth Giorgi, Dayrana Alves Lucena, Sônia Maria Alvarenga Anti Loduca Lima, Nathália de Carvalho Sacilotto, Roberta De Almeida Pernambuco, Rogério Duque de Almeida, Marcos Roberto Godoy, Roberto Sacilotto, and André Ozela Augusto
- Subjects
Carotid Artery Diseases ,medicine.medical_specialty ,Femoral artery ,Carotid Intima-Media Thickness ,Risk Assessment ,Asymptomatic ,Arthritis, Rheumatoid ,Rheumatology ,Risk Factors ,medicine.artery ,Internal medicine ,medicine ,Humans ,Framingham Risk Score ,business.industry ,Ultrasonography, Doppler ,medicine.disease ,Femoral Artery ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Homogeneous ,Rheumatoid arthritis ,Cardiology ,Female ,Doppler ultrasound ,medicine.symptom ,Risk assessment ,business ,Rheumatism - Abstract
OBJECTIVE The aims of this study were to assess cardiovascular risk in patients with rheumatoid arthritis (RA) classified as low-risk by the Framingham score, before and after the multiplication by 1.5 recommended by the European League Against Rheumatism (EULAR), and to stratify them using carotid and femoral Doppler ultrasound (DUS) in order to optimize the assessment of the asymptomatic cardiovascular disease incidence. METHODS Thirty-five female patients with RA and 35 healthy women (control group), both with low cardiovascular risk by Framingham score, were enrolled in the study (randomized). All of them underwent carotid and femoral DUS studies. RESULTS The mean age at diagnosis was 44.57 years, the mean disease duration was 12.11 years and the mean disease activity score according to the Disease Activity Score 28 was 1.91, whereas according to the Clinical Disease Activity Index, it was 6.176. The sample was homogeneous. Within the RA group, 46% showed changes in the carotid and/or femoral DUS, compared with 14% in the control group (p = 0.004). Of the DUS with abnormalities, in the RA group, 31% of the carotid DUS and 81% of the femoral DUS (p = 0.005) showed intima-media thickness and/or atherosclerotic plaques. After EULAR 1.5 multiplication factor, 66% remained low cardiovascular risk. Of these, 35% of the patients showed changes in the carotid and/or femoral DUS, compared with 14% of the control group (p = 0.07). CONCLUSIONS The EULAR criteria are effective at identifying patients with high cardiovascular risk. Carotid DUS and, especially, femoral DUS are tools that can be used in clinical practice as ways to detect CVD even in its asymptomatic form.
- Published
- 2021
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