SAT0651 Carotid ultrasound in patients with arthritis: ¿in which patients does it re-stratify cv risk?

Objectives To explore in which patients with inflammatory rheumatic disease, the findings in a carotid ultrasound result in a change in cardiovascular (CV) risk stratification as compared to the CV risk measured with the SCORE index. Methods Longitudinal prospective study in patients included in a program geared at CV risk factor screening followed by optimisation of their treatment. Patients with rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA) were included in the program. In a nurse-led single-visit, the existence and adequate control of classic CV risk factors were recorded. SCORE index was calculated and then modified according to EULAR recommendations. CV risks was stratified according to European guidelines. A carotid ultrasound was performed in patients with a low, intermediate or high-risk stratification in order to assess intimal-media thickness (IMT) and plaques. If plaques were detected, CV risk was re-stratified to very high risk. From this program, patients who had completed the baseline evaluation and the carotid ultrasound were selected. The characteristics of patients with findings in carotid ultrasound that allowed re-stratification to those without these findings were compared. Results A total of 181 patients have completed the baseline work-up, including the carotid ultrasound. 122 (67%) of the patients were women with a mean age of 55 (±11) years of age. Included patients had RA (n=96, 53%), SpA (n=37, 20%) or PsA (n=48, 27%). A diagnosis of DM was performed in 19 (10%), hypertension in 78 (43%) and hypercholesterolemia in 92 (51%); 38 (21%) were active smokers and 63 (35%) were obese (BMI >30). Mean SCORE index (modified according to EULAR recommendations) was 2.4 (±1.7). Risk stratification before ultrasound was 145 (80%) patients with intermediate risk and 36 (20%) with high risk. Carotid ultrasound imaging showed plaques in 43 patients (bilaterally in 14). In these, risk was re-stratified as very high risk. Overall, 11 patients showed a thickening of IMT; all presented plaques as well. Final risk stratification after including the carotid ultrasound findings showed 110 patients with intermediate risk, 28 with high risk and 43 with a very high risk. In table 1, the characteristics of the 43 patients whose carotid ultrasound findings resulted in a risk re-stratification vs the 138 with no risk modification. Conclusions Patients with risk modification due to carotid ultrasound findings were older and were more frequently hypercholesterolemic. Performing a carotid ultrasound in these patients seems to offer especially relevant information. Disclosure of Interest None declared