The role of non-invasive cardiovascular imaging in the assessment of cardiovascular risk in rheumatoid arthritis: where we are and where we need to be

First cardiovascular MRI study in individuals at risk of rheumatoid arthritis detects abnormal aortic stiffness suggesting an anti-citrullinated peptide antibody-mediated role for accelerated atherosclerosis

“…Overall, modest event rate has necessitated the use of surrogate CV abnormalities of increased CV risk including arterial stiffness. Increased arterial stiffness is well recognised in established RA,2 with early, similar reports using comprehensive and reliable cardiac MRI (CMRI) in our treatment-naïve, early onset RA cohort 3. Autopsy, histopathological and clinical studies in general population and RA cohorts with and without CV disease (CVD) suggest citrullinated proteins as a mechanism for atherosclerosis, including presence of citrullination within the atherosclerotic plaque of subjects without RA 4 5.…”

Gender aspects on exercise‐induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia

“…Moreover, in the current study, the diagnostic accuracy of the ST response in detecting the absence or presence of stress‐induced ischaemia by MPS was based on a holistic interpretation of the ST response and not on specific millimetre cut‐off values of ST depression, which is line with what has previously been shown about the need to go beyond specific millimetre thresholds in the interpretation of the ST response (Akil et al ., ). Females are known to have a higher rate of abnormal ST responses than males, as a non‐pathologic finding, making their diagnosis using EST more challenging (Sketch et al ; Fent et al ., ). Various possible explanations for this have been purposed, including digoxin‐like effect of oestrogen, haemoglobin concentrations and different chest wall anatomy in females (Sketch et al ., ; Kwok et al ., ).…”

Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case‐control study

“…There are non‐invasive, cost‐effective, and reproducible methods to assess CVD, such as ankle brachial pressure index, a marker of peripheral vascular disease, which is at least twice as high in RA patients compared to control subjects and has association with increased cIMT length . The carotid US is a helpful tool to evaluate subclinical atherosclerosis, and there is reasonable evidence to do carotid US in intermediate risk RA patients and reclassification of their CVR . The RA population has greater risk of adverse CV outcomes accumulating with the other risk factors, than that of the general population.…”