IMPACT OF RHEUMATOID ARTHRITIS ACTIVITY ON CARDIOVASCULAR RISK PREDICTION AND STATIN ELIGIBILITY: A MULTI-SCORE STUDY FROM IRAQ

Background: Cardiovascular disease risk is elevated in rheumatoid arthritis, which is a chronic inflammatory disorder affecting the entire body. Minimizing the occurrence of cardiovascular events in individuals with rheumatoid arthritis requires precise cardiovascular risk evaluation in addition to suitable statin treatment. However, because they do not account for rheumatoid arthritis specific variables, conventional cardiovascular risk calculators may understate risk. Aim of study: To evaluate the cardiovascular risk using several methods in rheumatoid arthritis patients, including determining the prevalence of patients who should be on statins and estimate the patients who achieve their lipids targets. Methods: A cross-sectional study was conducted on 430 rheumatoid arthritis patients in Baghdad Teaching Hospital during a period of two years from April 2024 till April 2026. Cardiovascular risk was assessed using QRISK-3, ASCVD, and Adjusted Framingham Score. Data on demographics, disease activity (DAS28), clinical, and laboratory variables were collected. Statin eligibility was determined according to each risk tool’s thresholds. Results: In this study, total eligibility for statins was 33.5%, with percentages varying by risk calculator: 31.6% according to QRISK-3, 22.3% according to ASCVD, and 6.3% according to AFS. With rheumatoid arthritis disease activity, the percentage of patients indicated to take a statin shot grew dramatically, reaching 76.8% of the most active individuals. Female gender, obesity, smoking, corticosteroid use, and high cholesterol were independent predictors of statin therapy. Conclusions: Cardiovascular risk assessment in rheumatoid arthritis patients depends heavily on the risk tool used, with QRISK-3 showing greater sensitivity likely due to inclusion of rheumatoid arthritis as a risk factor. Rheumatoid arthritis disease activity is strongly associated with higher cardiovascular risk and statin eligibility. These findings support the need for rheumatoid arthritis specific risk assessment in clinical practice.