Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in rheumatoid arthritis (RA) patients. Several cardiovascular risk (CVR) algorithms are used in RA patients to predict cardiovascular outcomes, underestimating the real CVR.

Objectives: To compare CVR algorithms with carotid US findings in RA patients without clinical ASCVD and identify which calculator is the best predictor that correlates with carotid plaque (CP).

Methods: A cross-sectional and descriptive study that included RA-patients aged 30 to 79 who fulfilled the 2010 ACR/EULAR 2010 Classification Criteria for RA. Patients with previous cardiovascular disease (myocardial infarction, stroke, or peripheral artery disease) were excluded. CVR was calculated using six algorithms: Globorisk, 2019 Hearts (WHO), QRISK3, ESR-RA, SCORE2, and PREVENT. A carotid ultrasound was performed on all study participants, and the presence of CP defined as a diffuse carotid intima-media thickness (cIMT) ≥1.2 mm or a focal thickness ≥0.5 mm. ROC curve analysis was performed to evaluate the different CVR algorithms’ performance with CP. The Youden index was calculated to select the optimum sensitivity, specificity, and negative and positive predictive values. A value of p ≤0.05 was considered statistically significant.

Results: A total of 263 patients with RA diagnosis were included. The prevalence of CP was 38.0%. Demographic characteristics and results are shown in Table 1 and Figure 1.

Conclusion: In our study, all algorithms had a significant discrimination for the presence of CP. However, the ERS-RA and the Hearts algorithms presented the best diagnostic accuracy with the greatest sensitivity and specificity in RA-patients. The other algorithms, including the novel CVR calculator, PREVENT, were shown to be less able to detect CP in our population.

REFERENCES: [1] Wah-Suarez MI, Galarza-Delgado DA, Azpiri-Lopez JR, et al. the best cardiovascular risk calculator to predict carotid plaques in rheumatoid arthritis patients. Clin Rheumatol 2018;37(9):2373-80.

Acknowledgements: NIL.

Disclosure of Interests: None declared.