C-reactive protein and 10-year cardiovascular risk in rheumatoid arthritis

Area of Science:

• Rheumatology
• Cardiology
• Inflammation Research

Background:

• Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular (CV) events.
• Conventional risk scores often do not fully capture the CV risk in RA patients.
• C-reactive protein (CRP) is a marker of inflammation that may contribute to CV risk in RA.

Purpose of the Study:

• To evaluate the association between C-reactive protein (CRP) and the 10-year risk of cardiovascular (CV) events.
• To assess this association using the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA) in RA patients without prior CV events.

Main Methods:

• A cohort of 1,251 RA patients from the CORDIS database was analyzed.
• The Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA) was calculated for each patient.
• Statistical analysis, including adjusted models and mediation analysis, was performed to assess the association between CRP and CV risk.

Main Results:

• After adjusting for DMARDs and biologics, CRP concentrations were significantly associated with the 10-year risk of CV events.
• Each 10 mg/L increase in CRP was associated with a 0.005 increment in the 10-year CV risk.
• Disease activity did not mediate the association between CRP and ERS-RA.

Conclusions:

• In RA patients without prior CV events, a 20 mg/L increase in CRP was associated with a 1% increase in 10-year CV event risk.
• Targeting residual inflammatory risk beyond conventional and RA-specific factors may further decrease CV event rates in RA.
• CRP is an important independent predictor of CV risk in RA patients.