Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound

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Objective: To compare the effectiveness of stratifying high cardiovascular disease (CVD) risk inpatients diagnosed with rheumatoid arthritis (RA) using the Framingham Risk Score (FRS), modifiedSystematic Coronary Risk Evaluation (mSCORE), 2013 American College of Cardiology/AmericanHeart Association...

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Autores: Enríquez-Luna, Michele, García-Galicia, Arturo, Arreguín-Reyes, Roberto, Marín-Márquez, Gerardo, Montiel-Jarquín, Álvaro José, Monterrosas-Sánchez, Samantha Beatriz, López-García, Diana, Tapia-Venancio, Maricarmen, Palacios-Figueroa, Deyaneira
Formato: artículo
Fecha de Publicación:2025
Institución:Universidad de San Martín de Porres
Repositorio:Horizonte médico
Lenguaje:español
OAI Identifier:oai:horizontemedico.usmp.edu.pe:article/3066
Enlace del recurso:https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066
Nivel de acceso:acceso abierto
Materia:Riesgo Cardiovascular
Artritis Reumatoide
Escalas
Ultrasonido Carotídeo
Heart Disease Risk Factors
Arthritis, Rheumatoid
Weights and Measures
Ultrasonography, Carotid Arteries
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dc.title.none.fl_str_mv Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
Riesgo cardiovascular en pacientes con artritis reumatoide: escalas clásicas versus ultrasonido carotídeo
title Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
spellingShingle Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
Enríquez-Luna, Michele
Riesgo Cardiovascular
Artritis Reumatoide
Escalas
Ultrasonido Carotídeo
Heart Disease Risk Factors
Arthritis, Rheumatoid
Weights and Measures
Ultrasonography, Carotid Arteries
title_short Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
title_full Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
title_fullStr Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
title_full_unstemmed Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
title_sort Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasound
dc.creator.none.fl_str_mv Enríquez-Luna, Michele
García-Galicia, Arturo
Arreguín-Reyes, Roberto
Marín-Márquez, Gerardo
Montiel-Jarquín, Álvaro José
Monterrosas-Sánchez, Samantha Beatriz
López-García, Diana
Tapia-Venancio, Maricarmen
Palacios-Figueroa, Deyaneira
author Enríquez-Luna, Michele
author_facet Enríquez-Luna, Michele
García-Galicia, Arturo
Arreguín-Reyes, Roberto
Marín-Márquez, Gerardo
Montiel-Jarquín, Álvaro José
Monterrosas-Sánchez, Samantha Beatriz
López-García, Diana
Tapia-Venancio, Maricarmen
Palacios-Figueroa, Deyaneira
author_role author
author2 García-Galicia, Arturo
Arreguín-Reyes, Roberto
Marín-Márquez, Gerardo
Montiel-Jarquín, Álvaro José
Monterrosas-Sánchez, Samantha Beatriz
López-García, Diana
Tapia-Venancio, Maricarmen
Palacios-Figueroa, Deyaneira
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Riesgo Cardiovascular
Artritis Reumatoide
Escalas
Ultrasonido Carotídeo
Heart Disease Risk Factors
Arthritis, Rheumatoid
Weights and Measures
Ultrasonography, Carotid Arteries
topic Riesgo Cardiovascular
Artritis Reumatoide
Escalas
Ultrasonido Carotídeo
Heart Disease Risk Factors
Arthritis, Rheumatoid
Weights and Measures
Ultrasonography, Carotid Arteries
description Objective: To compare the effectiveness of stratifying high cardiovascular disease (CVD) risk inpatients diagnosed with rheumatoid arthritis (RA) using the Framingham Risk Score (FRS), modifiedSystematic Coronary Risk Evaluation (mSCORE), 2013 American College of Cardiology/AmericanHeart Association (2013 ACC/AHA) guidelines and QResearch Risk Estimator version 3 (QRISK3),with carotid ultrasound (CUS) serving as the gold standard for detecting subclinical atherosclerosis.Materials and methods: A comparative, observational and cross-sectional diagnostic study was conducted in patients aged 40 to 75 years, of both sexes, with RA and without CVD, at a tertiarycare hospital in Puebla, Mexico. Patients on treatment with one or more disease-modifying antirheumatic drugs (DMARDs) for at least three months were included. Patients with chronic diseases and those who did not undergo a CUS were excluded. CVD risk was assessed using the aforementioned risk scales—with results adjusted by a factor of 1.5 (as recommended by the 2015/2016 European League Against Rheumatism guidelines)—andCUS to detect subclinical atherosclerosis. Results: A total of 70 out of 110 patients with high CVD risk were enrolled in the study: six (8.6 %), nine (12.9 %), three (4.3 %) and four (5.7 %) were diagnosed using FRS, 2013 ACC/AHA guidelines, QRISK3 and mSCORE, respectively. CUS detected subclinical atherosclerosis in 25 patients (35.71 %), of whom seven were classified as high CVD risk according to ACC/AHA guidelines (28 %, p = 0.006). The discriminatory power of the scales was found to be adequate(p < 0.05), with QRISK3 demonstrating the highest effectiveness (0.737, 95 % CI: 0.609-0.866); however, no significant differences were observed between the scales. Conclusions: The estimation of CVD risk in patients with RA remains suboptimal. The use of non-invasive imaging techniques provides valuable assistance in stratifying CVD risk. Although the scales demonstrated adequate discriminatory power, they were not equivalent and their correlation with subclinical atherosclerosis was low.
publishDate 2025
dc.date.none.fl_str_mv 2025-06-28
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066
10.24265/horizmed.2025.v25n2.08
url https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066
identifier_str_mv 10.24265/horizmed.2025.v25n2.08
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066/2224
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https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066/2303
dc.rights.none.fl_str_mv Derechos de autor 1970 Horizonte Médico (Lima)
https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Derechos de autor 1970 Horizonte Médico (Lima)
https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
text/xml
text/html
dc.publisher.none.fl_str_mv Universidad de San Martín de Porres. Facultad de Medicina Humana
publisher.none.fl_str_mv Universidad de San Martín de Porres. Facultad de Medicina Humana
dc.source.none.fl_str_mv Horizonte Médico (Lima); Vol. 25 No. 2 (2025): Abril-Junio; e3066
Horizonte Médico (Lima); Vol. 25 Núm. 2 (2025): Abril-Junio; e3066
Horizonte Médico (Lima); v. 25 n. 2 (2025): Abril-Junio; e3066
2227-3530
1727-558X
reponame:Horizonte médico
instname:Universidad de San Martín de Porres
instacron:USMP
instname_str Universidad de San Martín de Porres
instacron_str USMP
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spelling Cardiovascular risk in patients with rheumatoid arthritis: traditional scales versus carotid ultrasoundRiesgo cardiovascular en pacientes con artritis reumatoide: escalas clásicas versus ultrasonido carotídeoEnríquez-Luna, Michele García-Galicia, Arturo Arreguín-Reyes, RobertoMarín-Márquez, Gerardo Montiel-Jarquín, Álvaro José Monterrosas-Sánchez, Samantha Beatriz López-García, Diana Tapia-Venancio, Maricarmen Palacios-Figueroa, Deyaneira Riesgo CardiovascularArtritis Reumatoide Escalas Ultrasonido CarotídeoHeart Disease Risk FactorsArthritis, RheumatoidWeights and Measures Ultrasonography, Carotid ArteriesObjective: To compare the effectiveness of stratifying high cardiovascular disease (CVD) risk inpatients diagnosed with rheumatoid arthritis (RA) using the Framingham Risk Score (FRS), modifiedSystematic Coronary Risk Evaluation (mSCORE), 2013 American College of Cardiology/AmericanHeart Association (2013 ACC/AHA) guidelines and QResearch Risk Estimator version 3 (QRISK3),with carotid ultrasound (CUS) serving as the gold standard for detecting subclinical atherosclerosis.Materials and methods: A comparative, observational and cross-sectional diagnostic study was conducted in patients aged 40 to 75 years, of both sexes, with RA and without CVD, at a tertiarycare hospital in Puebla, Mexico. Patients on treatment with one or more disease-modifying antirheumatic drugs (DMARDs) for at least three months were included. Patients with chronic diseases and those who did not undergo a CUS were excluded. CVD risk was assessed using the aforementioned risk scales—with results adjusted by a factor of 1.5 (as recommended by the 2015/2016 European League Against Rheumatism guidelines)—andCUS to detect subclinical atherosclerosis. Results: A total of 70 out of 110 patients with high CVD risk were enrolled in the study: six (8.6 %), nine (12.9 %), three (4.3 %) and four (5.7 %) were diagnosed using FRS, 2013 ACC/AHA guidelines, QRISK3 and mSCORE, respectively. CUS detected subclinical atherosclerosis in 25 patients (35.71 %), of whom seven were classified as high CVD risk according to ACC/AHA guidelines (28 %, p = 0.006). The discriminatory power of the scales was found to be adequate(p < 0.05), with QRISK3 demonstrating the highest effectiveness (0.737, 95 % CI: 0.609-0.866); however, no significant differences were observed between the scales. Conclusions: The estimation of CVD risk in patients with RA remains suboptimal. The use of non-invasive imaging techniques provides valuable assistance in stratifying CVD risk. Although the scales demonstrated adequate discriminatory power, they were not equivalent and their correlation with subclinical atherosclerosis was low.Objetivo: Comparar el desempeño para la estratificación de un alto riesgo cardiovascular (RCV) en pacientes diagnosticados con artritis reumatoide (AR). Para su medición se utilizaron la escala de predicción de riesgo de Framingham (FRS), la evaluación de riesgo coronario con el modelo SCORE modificado (mSCORE), la escala de la Asociación Americana de Cardiología/Asociación Americana del Corazón (ACC/AHA 2013) y el rendimiento del estimador de riesgo QRESEARCH versión 3 (QRISK3), con ultrasonido carotídeo (USC) como estándar de oro para detectar la aterosclerosis subclínica. Materiales y métodos: Se realizó un estudio de pruebas diagnósticas, de tipo comparativo, observacional y transversal en pacientes de 40 a 75 años, de ambos sexos, con AR y sin enfermedad cardiovascular (ECV), en un hospital de tercer nivel en Puebla, México.Se incluyeron pacientes en tratamiento con uno o más fármacos modificadores de la enfermedad (FARME) durante un periodo mínimo de tres meses. Se excluyeron pacientes con enfermedades crónicas exclusivas y se eliminaron aquellos pacientes que no contaban con una ecografía carotídea. Se evaluó el RCV mediante las escalas mencionadas multiplicado por 1,5 (factor recomendado por la Liga Europea contra el Reumatismo 2015/2016), y por USC para evaluar la aterosclerosis subclínica. Resultados: Se incluyó en el estudio un total de 70 de 110 pacientes con alto RCV: sediagnosticaron 6 (8,6 %), 9 (12,9 %), 3 (4,3 %) y 4 (5,7 %) mediante las escalas FRS, ACC/AHA, QRISK3 y mSCORE, respectivamente. El USC encontró aterosclerosis subclínica en 25 pacientes (35,71 %). La ACC/AHA detectaron RCV alto en siete pacientes de los 25 con aterosclerosis (28 %, p = 0,006). La capacidad de discriminación de las escalas resultó adecuada (p < 0,05), y el QRISK3 fue el que mostró mejores cifras (0,737, IC 95 %: 0,609-0,866); sin embargo, no se observaron diferencias significativas entre las escalas. Conclusiones: La estimación de RCV en pacientes con artritis es subóptima. El uso de técnicas de imagen no invasivas facilita la estratificación del RCV. A pesar de que las escalas presentan una capacidad discriminativa adecuada, no son equivalentes, y su correlación con la aterosclerosis subclínica es baja.Universidad de San Martín de Porres. Facultad de Medicina Humana2025-06-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdftext/xmltext/htmlhttps://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/306610.24265/horizmed.2025.v25n2.08Horizonte Médico (Lima); Vol. 25 No. 2 (2025): Abril-Junio; e3066Horizonte Médico (Lima); Vol. 25 Núm. 2 (2025): Abril-Junio; e3066Horizonte Médico (Lima); v. 25 n. 2 (2025): Abril-Junio; e30662227-35301727-558Xreponame:Horizonte médicoinstname:Universidad de San Martín de Porresinstacron:USMPspahttps://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066/2224https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066/2257https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3066/2303Derechos de autor 1970 Horizonte Médico (Lima)https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessoai:horizontemedico.usmp.edu.pe:article/30662025-06-28T19:53:36Z
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