AB0355 CAROTID ULTRASOUND IS MORE EFFECTIVE THAN CORONARY CALCIFICATION ASSESSMENT FOR DETECTING INDICATIONS TO STATIN THERAPY IN RHEUMATOID ARTHRITIS PATIENTS

Abstract

Objectives To compare the significance of the carotid ultrasound and the MDCT assessment of coronary calcification in the stratification of cardiovascular risk and the detection of indications for lipid-lowering therapy in patients with RA. Methods Ninety two patients with RA are included (ACR/EULAR, 2010), 74% are women, the median of age is 54 [41.5; 60] years, median of disease duration - 6 [5; 21] months, median of DAS28 (ESR) – 5.2 [5.0; 6.0], without cardiovascular diseases and diabetes mellitus, severe chronic renal failure (GFR Results After assessing the cardiovascular risk on the mSCORE scale 41.3% of patients with RA were classified as low risk (n = 38), medium risk – 38% (n = 35), high risk – 15.2% (n = 14), very high risk– 5.5% (n = 5). Non-target lipid levels were detected in 44.7% of low-risk patients, in 83% of medium risk patients, in 78.6% of high risk patients, in 100% of very high risk patient. Absolute indications for statin therapy were detected in 17.4%. Hemodynamically insignificant carotid plaques (stenosis 75 percentile of the age- and sex-related reference values, in according to MESA): in 5.3% of low risk patients, in 37% of medium risk patients, in 28.6% of high risk patients, in 80% of very high risk. After carotid ultrasound 38% (34/92) of RA patients were reclassified from the category of low and medium cardiovascular risk on the mSCORE scale to the high risk category. The proportion of patients with high cardiovascular risk increased in 3.5 times (53.2%, p After MDCT assessment of coronary calcification 16.3% (15/92) of RA patients were reclassified from the category of low and medium cardiovascular risk on the mSCORE scale to the high risk category. The proportion of patients with high cardiovascular risk increased in 2.1 times (31.5%, p Conclusion The use of the mSCORE scale is not sensitive enough for stratification of cardiovascular risk in RA patients due to the high incidence of subclinical atherosclerosis in this population. The use of carotid ultrasound and the MDCT assessment of coronary calcification significantly improve the stratification of cardiovascular risk in patients with RA, which helps to identify patients requiring intensive prevention of cardiovascular complications. The frequency of identifying patients with absolute indications for statin therapy when performing carotid ultrasound is significantly higher than MDCT assessment of coronary calcification. Disclosure of Interests None declared