Clinical Edge

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Inflammation and Estimated CV Risk in RA

Arthritis Rheumatol; 2018 Sep; Yu, Yang, et al

There was no significant change in cardiovascular (CV) risk estimated in persons with rheumatoid arthritis (RA) using validated general population CV risk calculators, with the exception of the Reynolds Risk Score (RRS). This according to a recent study that was undertaken to test whether changes in inflammation in RA affect estimated CV risk as measured using validated population‐based risk calculators. Participants (n=180) in a prospective RA cohort who experienced a decrease or an increase of ≥10 mg/liter in the C‐reactive protein (CRP) level at 2 consecutive time points 1 year apart were included. Researchers estimated 10‐year CV risk using the following calculators: Framingham Risk Score, 2013 American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease Risk Score, RRS, and QRISK2. Of these calculators, only the RRS includes a variable addressing the CRP level. Paired t‐tests were performed to compare risk scores at baseline and 1‐year follow‐up. They found:

  • Of the calculators studied, only the RRS was sensitive to changes in inflammation.
  • An increase in inflammation was associated with increased estimated CV risk, and only the RRS was correlated with changes in pro-B-type natriuretic peptide (proBNP; r=0.17).


Yu Z, Yang N, Everett BM, et al. Impact of changes in inflammation on estimated ten-year cardiovascular risk in rheumatoid arthritis. Arthritis Rheumatol. 2018;70(9):1392-1398. doi:10.1002/art.40532.