Clinical and demographic features of cardio-vascular risk in female with rheumatoid arthritis according to mSCORE analysis results

Abstract

The aim of the research was to estimate the occurrence of cardio-vascular risk among patients with rheumatoid arthritis depending on age, status of menopause, dyslipidemia and clinical and laboratory features. Materials and methods. 50 female patients with confirmed diagnosis of rheumatoid arthritis were examined. Cardio-vascular risk was defined according to mSCORE with the following gradation: low, middle, high, very high level among women aged >45 years old. Laboratory diagnostics consisted of clinical and biochemistry blood analysis, determination of CRP, RF and ACCP. DAS28 was used for activity characteristic. Cholesterol, HDL, LDL, thyroglobulin, apoliprotein A1, apoliproteinB, uric acid, ATE, microalbuminuria were tested. Results. Estimation of cardio-vascular risk occurrence among patients older than 45 years old showed that the majority had a middle level of cardio-vascular risk whereas almost every fifth patient has a high level. Analysis of cardio-vascular risk occurrence according to mSCORE depending on patients’ age showed its significant elevation among patients elder than 45 years old and substantial differences in quantitative indices in group of patients aged 46 - 60 and >60. 83.3 % of reproductive age female patients did not show cardio-vascular risk, 11.1 % showed middle level and 5.6 % - low level of cardio-vascular risk. Only 3.9 % of postmenopausal women did not have a cardio-vascular risk, the majority (64.7 %) showed middle level, 25.5 % – high level and 3.9 % – very high level. The analysis revealed the presence of significant differences in patients older than 60 years old and the most of them demonstrated cardio-vascular risk more than 5 %. The majority of patients, who received immunobiological therapy (methotrexat), had cardio-vascular risk less than 5 %. Conclusions. Occurrence of cardio-vascular risk among women older than 45 years old with rheumatoid arthritis made 96% whereas its grater part was registered in patients older than 60 years old. Significantly higher quantitative indices of cardio-vascular risk according to mSCORE scale were observed in patients with high activity level of inflammatory process (CRP, TJC, SJC and DAS28 levels). Analysis of cardio-vascular risk occurrence indicated its increasing trend among women who did not receive immunobiological therapy. The tested group of patients with cardio-vascular risk of more than 5% showed dyslipidemia which was characterized by higher levels of cholesterol, LDL, apoliproteinB and significantly lower HDL concentration.