IMPACT OF RHEUMATOID ARTHRITIS ON CARDIOVASCULAR RISK: PATHOPHYSIOLOGY AND PREVENTION-A PROSPECTIVE COHORT STUDY
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Keywords
Rheumatology, Cardiovascular disease, Inflammation, Atherosclerosis.
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterised by chronic synovial inflammation, which considerably enhances the risk of cardiovascular disease (CVD). This study aimed to assess the impact of a structured, protocol-driven strategy to CVD risk management over a 6-month duration in patients with rheumatoid arthritis.
Methodology: A prospective, single-centre research study included 50 individuals with active rheumatoid arthritis. At baseline and 6 months, we measured disease activity (DAS28-ESR), systemic inflammation (CRP, ESR), lipid profiles, and cardiovascular disease risk using the QRISK3 score. All patients received protocolized care aimed at both RA disease control (treat-to-target strategy) and aggressive management of conventional cardiovascular disease risk factors.
Results: After 6 months, disease activity in rheumatoid arthritis improved significantly, with the mean DAS28-ESR decreasing from 5.2±0.8 to 2.9±0.7 (p < 0.001). Concurrently, systemic inflammatory indicators (CRP and ESR) decreased significantly (p<0.001). The mean QRISK3 score, which measures 10-year CVD risk, reduced dramatically from 12.5% to9.8% (p=0.005). The lipid profile also improved, with a rise in HDL-C (p=0.02).
Conclusion: A combined management strategy focusing on RA disease activity control and proactive management of conventional CVD risk factors over 6 months can result in a significant reduction in the predicted 10-year CVD risk. These findings highlight the important need for integrated care strategies in rheumatic practice to reduce the significant cardiovascular burden associated with rheumatic arthritis.
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Sajid Naseem
Department of Rheumatology, Fazaia Medical College, Islamabad, Pakistan
Khawaja Faizan Ejaz
Department of Rheumatology, Nottingham University Hospitals, Queens Medical Centre, United Kingdom
Hifza Ishtiaq
Department of Public Health, Abbas Institute of Medical Sciences, Muzaffarabad, Azad Jammu and Kashmir, Pakistan
Muhammad Iftikhar Khattak
Department of Public Health, Health Services Academy, Islamabad, Pakistan
Farwa Jaffery
Department of Cardiology, Kulsoom International Hospital, Islamabad, Pakistan
