Background: Patients with arthritis are at high risk of cardiovascular disease and cardiovascular mortality.

Objectives: To test the ability of an established traditional cardiovascular (CV) risk scores to identify early rheumatoid and psoriatic arthritis (RA and PsA) patients at high CV risk and to examine the associations of CV surrogate markers with clinical and immunological parameters in both these conditions.

Methods: We estimated the CV risk with the Systematic COronary Risk Evaluation 2 (SCORE2) charts, the algorithm “Progetto Cuore”, the QRISK2 score, the Reynolds Risk Score (RRS) and the Expanded Risk Score in RA (ERS-RA). Clinical disease activity index (CDAI) was used to define activity in RA, whereas DAPSA was used as marker of clinical activity in PsA. Global longitudinal and circumferential strain (GLS and GCS) was estimated. Pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) were measured as surrogate markers of atherosclerosis. Circulating CD34+ counts were evaluated by flow cytometry and vitamin D levels were quantified by HPLC. Wilcoxon signed-rank test was used to compare CV risk scores.

Results: We recruited 43 RA and 37 PsA patients and 52 controls. cIMT, PWV were increased in RA and PsA patients with respect to controls; furthermore, an impaired GLS and GCS score were found in arthritis patients then controls. The following patients were classified as having moderate CV risk: 14 (17.5%) by FRS, 1 (1 %) by SCORE2, 3 (3.7%) by PROGETTO CUORE, 2 (2.5%) by RRS and 15 (18.7%) by ERS-RA score. None of patients and controls had a high-risk score. A positive correlation was found between subclinical atherosclerosis (cIMT and PWV) and subclinical myocardial disfunction (GLS and GCS) with disease activity and markers of inflammation, and with CVD score: Progetto Cuore, REYNOLDS and ERS score. The discriminating capacity (to identify the presence of IMT>0.9 mm) of the five risk indices was found to be fair, with an AUC-ROC of 0.721 (95% CI 0.561–0.881) for PROGETTO CUORE, 0.667 (95% CI 0.498–0.836) for RRS, 0.658 (95% CI 0.477–0.838) for FRS, 0.696 (95% CI 0.528–0.864) for SCORE2 and 0.765 (95% CI 0.617–0.913) for ERS-RA. Multivariate analysis showed that Predictors of cIMT >0.9 mm was only ERS-RA score, instead CDAI only for GLS; Predictors of PWV were LDL and ERS-RA.

Conclusion: RA and PsA patients had higher carotid stiffness and Subclinical myocardial dysfunction compared with controls, even after adjustment for confounders. ERS-RA scores had a good correlation with cIMT, but almost a quarter of patients at low risk had a cIMT > 0.9 mm. In patients at low risk could be suitable to perform screening for subclinical CV damage in patients with early arthritis. Thus, markers of cardiac and endothelial damage may better stratify the cardiovascular risk in patients with arthritis also during the early phase.

REFERENCES: [1] Lo Gullo A, Rodríguez-Carrio J, Aragona CO, et al. Subclinical impairment of myocardial and endothelial functionality in very early psoriatic and rheumatoid arthritis patients: Association with vitamin D and inflammation. Atherosclerosis. 2018 Apr;271:214-22.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.