FRI0050 CARDIOVASCULAR RISK IN THE RHEUMATOID ARTHRITIS PATIENTS OF THE GULF CORPORATION COUNCIL-GCC: WHAT CONTRIBUTE TO THE CAROTID INTIMA MEDIA THICKNESS
Authors: Suad Hannawi, Haifa Hannawi, Issa Al Salmi
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Rheumatoid arthritis (RA) is a common inflammatory joints disease that occurs in 1-3% of population. RA patients are at higher risk of cardiovascular disease (CVD). This accelerated atherosclerosis can't be fully explained by the traditional CVD risk factors. The CVD risk factors had never been investigated in the RA patients of Gulf Corporation Council (GCC). <h3>Objectives</h3> For the first time, this study assesses the CVD as manifested by carotid intima media thickness (cIMT) and the CVD risk factors (traditional and non-traditional) in RA GCC-population. <h3>Methods</h3> 216 RA (179 (83%) F and 37 (17%) M) GCC patients, who were free of atherosclerosis (CVD &amp; Cerebrovascular diseases) included over 5 years (2013-2018). Diabetic, hypertensive, gout, renal and thyroid patients, pregnant, current smokers and those with history of smoking, and patients on diuretics medications were excluded. cMIT ultrasound (US) measurements were obtained using a real-time US scanner equipped with a 7.5-MHz linear probe. Blood tests (full blood counts, liver function, renal profile, and inflammatory markers), demography details, and body mass index (BMI) had been obtained within the same week of the cIMT scan. The correlation between cIMT and other variables were calculated using simple linear and multivariate regression analysis. <h3>Results</h3> The mean cIMT was 0.58 ± 0.11 mm (Min 0.28, Max 0.98). The mean age was 48 ± 13 years (48 ±12 yrs for females, 50±16 yrs for males, p= 0.279). univariate regression analysis showed a positive linear relationship between cIMT and age of the participants (p=0.001, CI: 0.00, 0.01), hemoglobin (Hb) (p=0.006, CI: 0.004, 0.023), hematocrit (p=0.006, CI: 0.001, 0.008), mean cell volume (MCV) (p=0.027, 0.000, 0.004), mean cell hemoglobin (p=0.04, CI: 0.000, 0.009), platelet (p= 0.000, CI: -0.001, -0.000), monocytes (p= 0.02, CI: 0.001, 0.018), eosinophils (p= 0.011, CI: 0.002, 0.018), erythrocyte sedimentation rate (ESR) (p=0.04, CI: 0.000, 0.001), creatinine (p=0.002, CI: .000, 0.002), uric acid (p=0.002, CI: 0.0001, 0.0004), triglycerides (p=0.033, CI: 0.002, 0.044), low density lipoprotein (LDL) (p=0.002, CI: 0.010, 0.045), C-reactive protein (p= 0.000, CI: 0.001, 0.002), ferritin (p=0.000, CI: 0.000, 0.001), body weight (Kg) (p=0.018, CI: 0.000, 0.002), body mass index (Kg/Ht<sup>2</sup>) (p=0.026, 0.000, 0.006), systolic blood pressure; Sbp (p= 0.000, CI: 0.001, 0.003), and diastolic blood pressure; dbp (p=0.001, CI: 0.001, 0.003). Negative linear relationship between cIMT and transferrin (p=0.001, CI: -0.001, 0.000), high density lipoprotein (p=0.000, CI: -0.103, -0.036), and glomerular filtration rate (GFR, ml/min) (p=0.024, CI: -0.0009, -0.00007). Multiple linear regression analysis showed a positive linear relation between cIMT and age of the participants (p= 0.000, CI: 0.002, 0.005), LDL (p= 0.003, CI: 0.012, 0.053), eosinophils (p= 0.025, CI: 0.001, 0.023), Sbp (0.004, CI: 0.001, 0.003), and the ESR (p= 0.016, CI: 0.002, 0.003). And, negative linear relationship with the GFR (p= 0.022, CI: 0.000, 0.002), and transferrin (p=0.000, CI: -0.001, -0.000). The R<sup>2</sup> of the model was 0.65. <h3>Conclusion</h3> For the first time we show that high hemoglobin, transferrin level and eosinophils count seem to have a role as a CVD risk factors in RA. The glucose fasting level is important CVD risk factor even in non-diabetic RA patients. The rest of the CVD risk factors in RA GCC population are like what had been demonstrated in other population (older age, high Sbp, ESR, LDL, and GFR level). <h3>Reference</h3> [1] Gabriel S. Cardiovascular morbidity and mortality in rheumatoid arthritis. Am J Medi. 2008;121:S9–S14. <h3>Disclosure of Interests</h3> None declared