Purpose:
To evaluate the ability of coronary
artery calcium scoring and carotid ultrasonography
to predict sub clinical
atherosclerosis
in Rheumatoid Arthritis
(RA) patients, to study the possible
risk factors compared with agematched
controls and correlate the
scoring
with disease characteristics
and
clinical variables. Material and
Methods:
Forty five patients with RA
with
no cardiovascular risks were included
and were compared to 45
age
and sex matched controls. All included
RA patients and control
group < br />are subjected to; clinical assessment
including Disease Activity
Score
28 (DAS28) , laboratory and
radiological
investigations. Radiologically,
carotid ultrasonography and multislice CT non enhanced coronary
calcium scoring and post contrast
coronary angiography were
done.
Results: RA patients have
higher
risk of cardiovascular disease
(CVD)
compared with control age
matched
group and at younger age.
Carotid
intimal medial thickness and
presence
of plaques are closely related
to the degree of coronary arteries
calcium scoring (CACS). Patients
with
higher CACS are more vulnerable
to cardiovascular diseases at
younger
age which is has higher incidence
in RA patients that the control
group.
63% of RA patients had
CACS>10
compared with 4.4% of ag
e
matched control group. Conclusion:
RA patients have higher risk of
coronary
arteries diseases especially
those
with higher disease activity. CT coronary arteries angiography
should be limited to patients with carotid
arteries ultrasound findings suspecting
high cardiovascular (CV)
risk.
CT coronary angiography is an
accurate imaging modality help in
early detection of subclinical athero-
sclerosis in RA patients as well as
identifying CV high risk groups.