Estimation of Ten - Year Cardiovascular Disease Risk in Patients with Rheumatoid Arthritis using QRISK 3

Aim: This study was initiated to assess the 10 -year cardiovascular disease risk in patients with Rheumatoid arthritis attending Rheumatology outpatient department in a tertiary care hospital in Kerala by using QRISK 3. Methods: 80 Rheumatoid arthritis patients between 25 to 84 years of age were selected from rheumatology outpatient department (OPD) at SK Hospital, Trivandrum. After 12 hours of fasting, venous blood was taken for total serum cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL), high density lipoproteins (HDL) and ESR. The disease outcome measure in RA patients was assessed by most validated composite tool entitled DAS 28. Much attention has been drawn to assess the cardiovascular risk in RA patients and was estimated using QRISK 3 online calculator. This gave us 10 -year cardiovascular risk in RA patients. The study appraised the involvement of disease activity in cardiovascular risk in RA patients and was carried out by multiple regression analysis. Results: The study included 80 rheumatoid arthritis patients with a mean age (in years) of 60±11. It has been found that 86.25% of the study population were female and the remaining were male. Presence of autoantibodies in RA patients were examined and the results showed that 73.7% of them were seropositive (either ACCP or RF positive). The study considered various comorbidities among the study population and the commonest comorbidity in RA patients was hypertension found in 41 (51.2%) patients.31 (38.7%) patients were overweight with mean body mass index (BMI) of 24.99 ± 3.45. Diabetes was found in 28 (35%) patients.53 (66.3%) had high low -density lipoprotein (LDL) whereas 33 (41.3%) had high total cholesterol (TC) and 11 (13.8%) had high triglyceride levels.8 (10%) patients were smokers. The current research confirmed the findings about cardiovascular risk in RA patients by means of QRISK 3 and stated that 36 (45%) patients had high cardiovascular risk, 21 (26.3%) had moderate risk and 23 (28.7%) had low cardiovascular risk. Multiple regression analysis accomplished the aim of examining the involvement of disease activity in QRISK 3 score and the results outlined the influence of high disease activity in increasing the cardiovascular risk. Conclusion: Rheumatoid arthritis patients encounter high cardiovascular risk and the high disease activity in RA patients intensify their cardiovascular risk in a significant level. Therefore, interventions to manage the conventional cardiac risk factors must be combined with the remedies to handle the disease activity. Consequently, attainment of satisfiable range of disease outcome could bring down a remarkable change in the cardiovascular risk outcome.