Carotid ultrasound in the cardiovascular risk stratification of patients with rheumatoid arthritis: when and for whom?

Annals of the Rheumatic Diseases
Miguel A Gonzalez-GayJavier Llorca

Abstract

Adequate stratification of cardiovascular (CV) risk is one of the major points of interest in the management of patients with rheumatoid arthritis (RA). A task force of the European League Against Rheumatism has proposed to adapt CV risk management calculated in RA patients according to the systematic coronary risk evaluation (SCORE) function by application of a multiplier factor of 1.5 in those patients with two of the following three criteria: disease duration >10 years, rheumatoid factor (RF) or anticyclic citrullinated peptide (anti-CCP) antibody positivity, and presence of severe extra-articular manifestations. However, a major concern when using the modified SCORE is to know whether the effect of chronic inflammation on the CV risk of RA patients can be fully determined using this tool. As increased carotid intima-media thickness (IMT) and carotid plaques have been proved to predict the development of CV events in RA, the authors suggest performing carotid ultrasound when SCORE does not yield results indicating high CV risk in RA patients with extra-articular manifestations, RF or anti-CCP positivity as well as in patients with 10 years disease duration or longer. The presence of abnormal carotid IMT (>0.90 mm) or carotid...Continue Reading

Citations

Apr 16, 2016·Seminars in Arthritis and Rheumatism·Christina Charles-SchoemanRichard Riese
Oct 2, 2012·Mediators of Inflammation·Lorenzo CavagnaRoberto Caporali
Jun 9, 2016·Clínica e investigación en arteriosclerosis : publicación oficial de la Sociedad Española de Arteriosclerosis·Miguel A González-Gay, Carlos González-Juanatey
Nov 30, 2019·Expert Review of Clinical Immunology·Santos CastañedaMiguel A González-Gay
Feb 10, 2021·Annals of the Rheumatic Diseases·Athanasios N GeorgiadisAlexandros A Drosos
May 31, 2020·Reumatología clinica·Esther F Vicente-RabanedaSantos Castañeda

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