MONOCYTE TO HIGH DENSITY LIPOPROTEIN RATIO AS CARDIOVASCULAR RISK FACTOR FOR PATIENTS WITH LONG STANDING RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY USING SIMPLIFIED DISEASE ACTIVITY INDEX (S-DAI).

Background: Rheumatoid arthritis (RA), is a chronic auto-immune joint disorder in which the risk of cardiovascular disease (CVD) remains significantly heightened, attributed to an inflammation state. The aim of this study was to evaluate the association between MHR ratio and cardiovascular risk, as well disease activity measured with Simplified Disease Activity Index (S-DAI), in patients with long-standing RA. Methods: This cross-sectional study was conducted at the Department of Rheumatology of Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2024 to June 2024. The rheumatoid arthritis was diagnosed using the 2010 ACR/EULAR Classification Criteria Score (score > 6). MHR ratio is the monocyte count (measured by the Sysmex 1000 Analyzer)/HDL levels. The disease activity was determined using the Simplified Disease Activity Index (S-DAI). Results: The study sample included 68 patients with long-standing RA (mean age of 52.41 ± 10.96 years). Out of sixty-eight patients 75% were female and 25% were male. In association of cardiovascular risk factors with disease activity in patients with rheumatoid arthritis, the prevalence of obesity and diabetes mellitus was found to be higher in low activity (43.5%) and (38.5%). The prevalence of hypertension is the highest among those in the low activity group (42.9%).and decreases in moderate activity (14.3%). None of these risk factors including smoking (p = 0.833), obesity (p = 0.983) and Carotid plaque (p = 0.780) were found to be significant. Conclusion: The findings of the study showed insignificant association of Monocyte to High-Density Lipoprotein (MHR) ratio with cardiovascular risk factors or disease activity in long-standing rheumatoid arthritis (RA). However, MHR may have predictive in other conditions, its role as a predictor in RA cardiovascular risk and disease severity has not yet been established.