Abstract Background Rheumatoid Arthritis (RA) is a chronic autoimmune disease associated with systemic inflammation and a potential increased risk of subclinical atherosclerosis. Coronary Artery Calcium (CAC) is a marker of atherosclerotic disease events. Purpose The aim of this study was to evaluate the cross-sectional association of CAC prevalence and the prospective 4-year follow-up associations of CAC incidence and progression in individuals with and without RA, free of prior cardiovascular conditions at baseline, using data from a large multicentre cohort study. Methods A case-cohort study was conducted with 76 participants with RA and 441 controls without RA, selected from a randomly assigned subcohort at baseline from a prospective cohort study of adults aged 35–74 years. This analysis included baseline (2008–2010) and 4-year follow-up data (2012–2014). RA diagnosis was based on physician confirmation, use of disease-modifying antirheumatic drugs, or positive serological biomarkers. CAC was measured using computed tomography, and Agatston scores were calculated. Associations between RA and CAC prevalence, incidence, and progression were assessed using linear regression for log (CAC+1), logistic regression for CAC 0, and Poisson regression for CAC incidence and progression. CAC progression was evaluated using Berry, Hokanson, and Raggi criteria. Models were adjusted for sociodemographic and cardiovascular risk factors. P-value 0.05 was considered statistically significant. Results The mean ± SD age of participants was 50.5 ± 8.5 years, with 55.5% being women. Participants with RA were significantly older (53.2 ± 8.7 vs 50.0 ± 8.3 years) and more likely to be female (82.9% vs 50.8%). At baseline, no significant differences were observed between groups for CAC prevalence when assessed as a continuous log-transformed variable (log CAC+1: β = 0.18, 95% CI: -0.24 to 0.60; p = 0.402) or as a categorical variable (CAC ≥ 0: Odds Ratio (OR) = 1.18, 95% CI: 0.59 to 2.28; p = 0.635). Similarly, for CAC incidence after 4 years of follow-up, no significant difference was found (Relative Risk (RR) = 0.84, 95% CI: 0.34 to 2.07, p = 0.700), and CAC progression also showed no significant results using the Berry, Hokanson, and Raggi criteria (Table 1). Conclusion There was no evidence of a significant association between RA and CAC prevalence, incidence after 4 years of follow-up, or progression. The relatively short follow-up period may have contributed to the lack of association observed in our findings.
Estrada et al. (Sat,) studied this question.