Background/Purpose: The most common cause of mortality in RA patients is the cardiovascular disease (CVD), with almost twice the risk for CVD events. Nailfold videocapillaroscopy (NVC) has emerged as an important tool for predicting severe organic disease in several rheumatic diseases. Although a correlation between NVC findings and CVD stratification risk has been poorly explored, NVC may be used as an early predictor for CVD risk. Our objective in this study was to evaluate the correlation between Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ESR-RA) scale and NVC morphological data.

Methods: This was cross-sectional study conducted in a single center; patients with RA according to the 2010 ACR/EULAR classification criteria were recruited. NVC was performed according to a standard method with a videocapillaroscope equipped with image analysis software (DinoCapture2.0). The following parameters were obtained: 1) demographic characteristics, 2) degree of enlarged capillaries, giant capillaries, tortuous capillaries, capillary density, disorganization of vascular array, meandering capillaries, ecstatic capillaries and ramified capillaries assessed by a semi-quantitative method 3) ESR-RA scale using the 10 years ERS-RA Risk Score Calculator for CVD risk. Correlation among individual capillaroscopy parameters with ESR-RA and RA disease duration was performed by Spearman’s rank correlation test.

Results: A total of 104 patients were analyzed (85.4% female; age 49.8±11.83 years). The mean disease duration was 7.4±6.67 years. Raynaud’s phenomenon was observed in 14.6%. The median ESR-RA score was 7.99% (IQR 1-54). A highest ESR-RA score correlated significantly with meandering capillaries (Rho 0.2459; p=0.012), disorganization of vascular array (Rho 0.276; p=0.004) and tortuous capillaries (Rho 0.1914; p=0.05). Significantly longer disease duration correlated with lower density (Rho -0.1961; p=0.047), meandering capillaries (Rho 0.2844; p=0.0036), ecstatic capillaries (Rho 0.2192; p=0.027), disorganization of vascular array (Rho 0.3655; p<0.001) and tortuous capillaries (Rho 0.1935; p=0.05).

Conclusion: In this study, a correlation between the ESR-RA scale, longer disease duration and different capillaroscopic findings was demonstrated in patients with RA. Our findings suggest that capillaroscopy can be considered as a transcendent tool of the evaluation in patients with RA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-correlation-study-between-expanded-cardiovascular-risk-prediction-score-for-rheumatoid-arthritis-and-nailfold-videocapillaroscopy/