Background: Rheumatoid Arthritis (RA), the prototype of chronic systemic inflammatory diseases, has a

mortality of 1.3 to 3 times higher than the general population, where cardiovascular

mortality is 40-50%. Now, we know there are increased risk of heart attack (RR: 2.0 - 2.13)

and cerebrovascular stroke (RR: 1.48 - 1.94), considering cardiovascular disease as an extra-

articular manifestation of RA, being independent risk factor of the traditional, with a high

risk of cardiovascular disease (OR: 1.5 – 4.0). This led to the search for additional tools that

help to identify the cardiovascular risk more accurately. Currently, the use of carotid

ultrasound has been the best option, considering that the measurement of the carotid

intima-media thickness and the presence of atheromatous plaques (AP) a non-invasive

method and surrogate marker of subclinical arteriosclerosis.

Objectives: Establish if the findings of subclinical arteriosclerosis by carotid ultrasound can be a good predictor of the development of cardiovascular events in a cohort of patients with RA at 10 years.

Methods: A cohort of patients with RA treated in the rheumatology outpatient of a hospital in Castilla La Mancha (Ciudad Real) was evaluated during the year 2013. A prospective evaluation was carried out for the development of CV events over the 10 years and their correlation with the previous ultrasound findings of IMT and PA.

Results: 8 (24%) patients presented a cardiovascular event. 3 (9%) heart failure, 3 (9%) cerebrovascular stroke, and 2 (6%) ischemic heart disease. RA patients who developed CVD had a higher IMT (0.97±0.08) compared to the rest of RA patients who did not have CV complications (0.74±0.15). (p=0.003). The presence of an IMT > or= 0.9mm and atheromatous plaque presented a relative risk of 12.25 (p 0.012) and 18.66 (p 0.003), respectively, for the development of a cardiovascular event.

Conclusion: Carotid ultrasound in patients with RA could allow early detection of subclinical atherosclerosis before the development of CVD, with IMT > or = 0.9mm being the finding most associated with CVD and not influenced by age.

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Acknowledgements: NIL.

Disclosure of Interests: None declared.