Cardiovascular Events Risk Factors in Patients with Rheumatoid Arthritis

Abstract

The objective: is to assess cardiovascular risk and fatal cardiovascular events with consideration of classical and additional cardiovascular risk factors in patients with rheumatoid arthritis.Materials and methods. 56 patients with rheumatoid arthritis aged 48,7±9,52 years were examined. The average disease duration was 9,8±2,7 years. In all patients, classical risk factors of cardiovascular diseases development were determined. 10-year coronary risk according to theFramingham scale and a 10-year fatal risk according to the SCORE scale were calculated for all patients. As additional cardiovascular risk factors markers of systemic inflammation, parameters of the hemostasis system, markers of endothelial dysfunction and damage were studied.Results. At screening for classic cardiovascular factors, the 10-year coronary risk according to the Framingham scale in patients with rheumatoid arthritis was 4,0 %, which was significantly lower than the corresponding risk for a population of a comparable gender and age without rheumatoid arthritis. The 10-year risk of fatal cardiovascular events according to the SCORE scale in the examined patients was 1,0 %, which can be considered as low level of risk. Analysis of additional cardiovascular risk factors allowed to reveal an increase in the C-reactive protein and fibrinogen levels, and a decrease of APTT one. Correlations were revealed between the activity of system inflammation and changes in the hemostasis system (platelet count, APTT, fibrinogen level). Patients with RA showed signs of endothelial damage and its dysfunction, which were significantly correlated with parameterd of system inflammation.Conclusion. The risk of cardiovascular pathology development and fatal cardiovascular events in patients with rheumatoid arthritis, calculated only with classical risk factors scales, is close to the general population one. An analysis of additional risk factors indicates that patients with rheumatoid arthritis show signs of endothelial damage and dysfunction, as well as increased prothrombogenic potential, which are directly related to the activity of systemic inflammation and contribute to the development of high cardiovascular risk in rheumatoid arthritis.