BMC Rheumatol. 2026 Jan 20. doi: 10.1186/s41927-026-00613-3. Online ahead of print.
ABSTRACT
BACKGROUND: Rheumatoid arthritis (RA) is a systemic inflammatory disorder associated with a significantly increased risk of cardiovascular events. This study aims to assess the prevalence of coronary artery disease (CAD) and its associated risk factors among Palestinian patients with RA, a population for which this data has been lacking.
METHODS: A cross-sectional study was conducted from March to September 2024 at multiple rheumatology clinics in the West Bank, Palestine. The study included 384 patients with a confirmed RA diagnosis based on the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria. Data were collected on demographic characteristics, traditional cardiovascular risk factors, and RA-specific factors, including disease activity measured by the Disease Activity Score 28 (DAS28) and C-reactive protein (CRP) levels. Multivariable analysis was used to identify independent predictors of CAD.
RESULTS: The prevalence of CAD in this cohort was 25.5%. Multivariable analysis revealed that CAD was independently predicted by increasing age, dyslipidemia, and a first-degree family history of CAD. Markers of systemic inflammation, specifically higher disease activity (DAS28 Prevalence Ratio = 1.309) and elevated CRP levels (PR up to 2.108 for levels > 10 mg/L), also emerged as potent and independent predictors. Furthermore, a paradoxical, non-linear association was observed with anti-CCP antibody status, where low-positive titers conferred the highest risk (PR = 1.811), and a modest inverse association with BMI was noted (PR = 0.992), consistent with the 'obesity paradox'.
CONCLUSION: This study reveals a high prevalence of CAD among Palestinian patients with RA, driven by both traditional metabolic risk factors and RA-related systemic inflammation. The findings highlight an urgent need to integrate proactive cardiovascular disease prevention into the standard of care for RA in Palestine, recognizing RA as a cardiovascular risk-equivalent condition.
PMID:41559843 | DOI:10.1186/s41927-026-00613-3