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Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective
Piero Ruscitti1, Paola Cipriani1, Francesco Masedu2
1Division of Rheumatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
Insights
Rheumatoid arthritis patients face increased risks of cardiovascular events and atherosclerosis. Traditional cardiovascular risk factors and disease-related issues significantly predict these outcomes over one year.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Epidemiology
Background:
- Rheumatoid Arthritis (RA) is linked to cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis.
- Understanding predictive factors for CVEs and atherosclerosis in RA is crucial.
Purpose of the Study:
- To investigate the incidence of CVEs and subclinical atherosclerosis in RA patients.
- To evaluate traditional cardiovascular (CV) and disease-related risk factors for predicting these outcomes.
Main Methods:
- Prospective, observational study at a single center.
- 347 RA patients were followed for 12 months.
- Statistical analyses identified predictive factors for CVEs and subclinical atherosclerosis.
Main Results:
- Increased incidence of CVEs, subclinical atherosclerosis, hypertension, diabetes, and metabolic syndrome observed.
- New onset hypertension and metabolic syndrome, older age, family history of CVEs, and poor clinical response predicted increased risk.
- These factors were associated with higher risks of CVEs and subclinical atherosclerosis.
Conclusions:
- The study quantifies an elevated risk of CVEs in RA patients over one year.
- Inflammatory burden and traditional CV risk factors contribute to CVEs and subclinical atherosclerosis in RA.
Objectives:
Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis.
Methods:
We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis.
Results:
We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis.
Conclusions:
Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors.
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