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Background Atherosclerotic cardiovascular disease (ASCVD) is the main mortality cause in patients with rheumatoid arthritis (RA) (1). It has been proven that the carotid intima-media thickness (CIMT) measured with carotid duplex ultrasonography (US) is an important ASCVD predictor with a measurement ≥0.9 mm (2–4). Objectives To characterize the disease factors related with abnormal carotid duplex US findings in Mexican mestizo patients with RA. Methods In a cross-sectional setting, we enrolled consecutive RA patients. Patients with overlap syndromes, personal history of ASCVD, dyslipidemia and previous use of any statin were excluded. A board-certified radiologist performed a bilateral carotid duplex US to all patients. Abnormal CIMT was defined as ≥0.9 mm (hypertrophy ≥0.9 – 1.2 mm and carotid plaque ≥1.2 mm). A clinical history and blood tests were performed at the time of the patient9s visit. Disease activity was measured with Disease Activity Score using 28 joints–C-reactive protein (DAS28-CRP). Results We enrolled 57 patients. Demographic characteristics are shown in table 1. A total of 30 (52.2%) patients had an abnormal CIMT. US findings are shown in table 2. A significant correlation between abnormal CIMT and RA disease duration (p=0.04), as well as between the former and anti-cyclic citrullinated peptide antibodies (ACPA) positivity (p=0.033) was found. Conclusions There is a strong relationship between CIMT and the chronic inflammatory process of RA, as well as ACPA positivity. These results might be influenced by the high mean disease duration of our patients. Prospective studies that evaluate CIMT among disease duration intervals are necessary to support these findings. References Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2012;71(9):1524–9. Galarza-Delgado DA, Esquivel-Valerio JA, Garza-Elizondo MA, Gongora-Rivera F, Munoz-De Hoyos JL, Serna-Pena G. Carotid atherosclerosis in patients with rheumatoid arthritis and rheumatoid nodules. Reumatol Clin. 2013;9(3):136–41. Mateo I, Morillas P, Quiles J, Castillo J, Andrade H, Roldan J, et al. What measure of carotid wall thickening is the best atherosclerotic loading score in the hypertensive patient: maximum or mean value? Rev Esp Cardiol. 2011;64(5):417–20. Disclosure of Interest None declared

Background Patients with rheumatoid arthritis (RA) have a higher risk to develop cardiovascular complications than general population (1), leading to a decrease in life expectancy of 3 to 10 years (2). RA is associated to increased left ventricle mass, pericardial effusion and diastolic dysfunction (3). Objectives The aim of this study was to assess the structure and function of the left ventricle in patients with RA and compare the results with matched controls. Methods We designed an observational cross-section case-control study. Patients diagnosed with RA according to the 1987 ACR and/or 2010 ACR/EULAR classification criteria, 40–75 years old, with no overlap syndromes, atherosclerotic cardiovascular disease or hypertension were included. Subjects for the control group were matched by sex, age and comorbidities. A board-certified cardiologist performed a transthoracic echocardiogram. Results We included a total of 44 RA-patients and 26 control subjects. Table 1 summarizes the demographic characteristics for each group. Left ventricular concentric remodeling (LVCR), defined as a relative wall thickness (RWT) >0.42 cm and a left ventricular mass index (LVMI) ≤95 gm/m2 in women and ≤115 gm/m2 in men, was found in 14 patients (32.6%) of the RA-group and 2 subjects (8%) of the control group; this difference was statistically significant (p=0.021). When we analyzed general abnormalities of left ventricle (either LVCR or left ventricular concentric hypertrophy [RWT >0.42 cm and LVMI >95 gm/m2 in women, >115 gm/m2 in men]) we found 15 RA patients (34.1%) with abnormalities and 3 subjects in the control group (11.5%) (p=0.037). There were no statistically significant differences among the groups in LVMI, diastolic dysfunction, global longitudinal strain or ejection fraction. Conclusions Left ventricle concentric remodeling is more prevalent in RA-patients when compared to controls. Further research is needed to determine the impact of these findings in the clinical prognosis of RA-patients. References Solomon DH, Curhan GC, Rimm EB, Cannuscio CC, Karlson EW. Cardiovascular risk factors in women with and without rheumatoid arthritis. Arthritis & Rheumatism. 2004;50(11):3444–9. Myasoedova E, Davis JM, Crowson CS, Gabriel SE. Epidemiology of Rheumatoid Arthritis: Rheumatoid Arthritis and Mortality. Current Rheumatology Reports. 2010;12(5):379–85. Corrao S, Messina S, Pistone G, Calvo L, Scaglione R, Licata G. Heart involvement in Rheumatoid Arthritis: Systematic review and meta-analysis. International Journal of Cardiology. 2013;167(5):2031–8. Disclosure of Interest None declared

Background Patients with rheumatoid arthritis (RA) have a significantly increased risk for cardiovascular (CV) morbidity and mortality when compared to general population (1). Preventive cardio-rheuma clinics have been created in recent years and proven to be effective to manage CV risk in patients with inflammatory joint diseases around the world (2). Objectives To evaluate the need for lipid-lowering intervention in Mexican mestizo patients with RA. Methods We initiated a preventive cardio-rheuma clinic for appropriate CV disease prevention in patients with RA in our population. A complete evaluation and CV risk stratification was performed to our patients, including blood tests and ultrasound examination of both carotid arteries. Each patient was classified to lifestyle changes only, a lifestyle intervention plus lipid-lowering treatment, or to have a low risk with no need for intervention, in accordance to the 2012 European Guidelines on cardiovascular disease prevention in clinical practice and the 2016 ESC/EAS Guidelines for the Management of Dyslipidemias. Results A total of 100 patients were evaluated, patient characteristics and intervention group distribution are shown in Table 1. Among these patients, 49 were found not to need any lipid-lowering intervention. The remaining 51 were classified into lifestyle change (n=18, 35.3%) or lipid-lowering drug regimens (n=33, 64.7%). A significant difference between intervention groups was only found regarding age (p Conclusions There was indication for preventive intervention in more than half of our patients. Age is a determinant factor that increases CV risk in RA patients independently from disease-specific factors. Treatment to lipid targets is essential to reduce their risk of CV morbidity and mortality (3). A prospective study evaluating treatment success rate is needed to further evaluate the intervention of the clinic. References Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, et al. Comparison of statin eligibility according to the Adult Treatment Panel III, ACC/AHA blood cholesterol guideline, and presence of carotid plaque by ultrasound in Mexican mestizo patients with rheumatoid arthritis. Clin Rheumatol. 2016;35(11):2823–7. Rollefstad S, Kvien TK, Holme I, et al. Treatment to lipid targets in patients with inflammatory joint diseases in a preventive cardio-rheuma clinic. Ann Rheum Dis. 2013;72(12):1968–74. Rollefstad S, Ikdahl E, Hisdal J, Olsen IC, et al. Rosuvastatin-Induced Carotid Plaque Regression in Patients With Inflammatory Joint Diseases: The Rosuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and Other Inflammatory Joint Diseases Study. Arthritis Rheumatol. 2015;67(7):1718–28. Disclosure of Interest None declared

Background Rheumatoid Arthritis (RA) is associated to subclinical atherosclerosis. Traditional risk factors for cardiovascular outcomes do not explain completely the higher risk, which could be caused by chronic systemic inflammation. Objectives The aim of this study is to relate abnormal carotid intima-media thickness (CIMT) to the presence of cardiovascular risk factors. Methods Observational cross-section design. We included patients who fulfilled the 1987 ACR and/or 2010 ACR/EULAR classification criteria for RA, 40 to 75 years old, with no personal history of atherosclerotic CV disease. A board-certified radiologist performed carotid duplex ultrasounds. Patients were distributed in two groups according to the absence (Group 1) or presence (Group 2) of traditional risk factors for cardiovascular disease (smoking status, dyslipidemia, high blood pressure and diabetes). Results A total of 82 patients were included. Demographic characteristics for each group are shown in Table 1. Ultrasound findings are shown in Table 2. CIMT alterations were more common in Group 2 (66.7%) than in Group 1 (38.7%), with statistical significance (p=0.013). Presence of carotid plaque was more common in Group 2 (27.5%) than in Group 1 (16.1%), shown clinical relevance, although did not shown statistical significance (p=0.18). Conclusions In this cohort of Mexican patients with RA, we demonstrate relation between the presence of alterations in CIMT (carotid hypertrophy and carotid plaque) and risk factors for cardiovascular disease, which can be enhanced by intrinsic risk of RA. These findings reaffirm the importance of global health assessment in patients with RA to reduce morbidity. References Avina-Zubieta JA. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2012;71(9):1524–9. Galarza-Delgado DA, Serna-Pena G. Carotid atherosclerosis in patients with rheumatoid arthritis and rheumatoid nodules. Reumatol Clin. 2013;9(3):136–41. Mateo I, What measure of carotid wall thickening is the best atherosclerotic loading score in the hypertensive patient: maximum or mean value?]. Rev Esp Cardiol. 2011;64(5):417–20. Disclosure of Interest None declared

Background Patients with rheumatoid arthritis (RA) have an increased risk of developing comorbid conditions which are associated to increased mortality, hospital admissions, higher costs of care and inability to work (1, 2). Objectives To evaluate the prevalence of comorbidities in a Mexican mestizo population of RA patients. Methods We performed a cross-sectional study in which RA patients who were admitted to our outpatient clinic between August 2014 and December 2016 were consecutively enrolled. We collected data regarding demographics, disease characteristics (activity, severity, treatment), comorbidities (cardiovascular, infections, cancer, and osteoporosis), and performed blood tests at the time of the patient9s visit to the clinic. Results We analyzed 225 patients. Their characteristics are shown in Table 1. Age, 55.7±8.3 years (mean ± SD); disease duration, 9.5 (4 – 15.5) (median (IQR)); female gender, 93.7%; Disease Activity Score using 28 joints–C-reactive protein (DAS28-CRP), 3 (2 – 4) (median (IQR)); past or current methotrexate use, 84.9%; past or current use of any other conventional disease modifying anti-rheumatic drug (cDMARD), 52.4%; past or current use of biological agents, 8%. The most frequently associated diseases were: hypertension, 29.8%; dyslipidemia, 27.1%; osteoporosis, 19.1%; diabetes, 12.4%; hypothyroidism, 6.2%; solid malignancies (excluding basal cell carcinoma), 4.4%. Risk factors were also evaluated, the most prevalent was overweight (BMI ≥25 Conclusions This study confirms the high prevalence of comorbidities in RA patients. Among our cohort, 63.5% had at least one comorbidity, being those associated with cardiovascular disease the most common. With a systematic assessment (3) including a thorough physical examination, vital signs and laboratory tests, it is possible to detect comorbid conditions that would otherwise remain unrecognized. References Dougados M, Soubrier M, Antunez A, Balint P, Balsa A, Buch MH, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014;73(1):62–8. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009;11(3):229. Baillet A, Gossec L, Carmona L, Wit M, van Eijk-Hustings Y, Bertheussen H, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Ann Rheum Dis. 2016;75(6):965–73. Disclosure of Interest None declared

Background The main cause of death in patients with rheumatoid arthritis (RA) is atherosclerotic cardiovascular disease. Speckle Tracking Echocardiography (STE) is an imaging technique that analyses the local and global myocardial function by assessing the myocardial deformation (strain). This technique is useful in addressing early alterations in ischemic pathologies (1,3). Objectives The aim of this study was to analyze if longitudinal strain abnormalities correspond with vascular territories, and compare the results between RA-patients and matched controls. Methods An observational cross-section case-control study was designed. Patients that fulfilled the 1987 ACR and/or 2010 ACR/EULAR classification criteria for RA, were 40–75 years old, with no overlap syndromes and no history of atherosclerotic cardiovascular disease were included. The control group was integrated by age- and sex-matched subjects, with no rheumatologic or cardiovascular diseases. A standard transthoracic echocardiogram was performed by a board-certified echocardiographer. Affection of coronary territories was compared between groups using longitudinal strain by speckle tracking according to the European Society of Cardiology and the American Society of Echocardiography recommendations. Results A total of 53 RA-patients and 24 control subjects were included. Demographic characteristics for each group are shown in table 1. There was no statistical difference in global longitudinal strain between RA-patients and controls (-20.86±2.82 vs -21.19±2.46, p=0.62). Comparison of longitudinal strain values of the three vascular territories evaluated between RA-patients and controls did not reach statistical difference (Table 2). Conclusions Contrary to previous published evidence (1, 2), there was no statistical difference in global longitudinal strain between RA patients and controls. Coronary territories are not affected in RA patients in comparison with controls. Further studies with a larger cohort are necessary to determine the usefulness of strain in the evaluation of subclinical cardiovascular disease. References Fine et al. Evaluation of myocardial function in patients with rheumatoid arthritis using strain imaging by speckle-tracking echocardiography, Ann Rheum Dis. 2014 Oct;73(10):1833–9. Sitia S, Tomasoni L, Cicala S, et al. Detection of preclinical impairment of myocardial function in rheumatoid arthritis patients with short disease duration by speckle tracking echocardiography. Int J Cardiol 2012;160:8–14. Batir et al, Herz. 2015 Jun;40(4):669–74. Preclinical impairment of myocardial function in rheumatoid arthritis patients. Detection of myocardial strain by speckle tracking echocardiography. Disclosure of Interest None declared