Impact of Nurse-led Programme With Carotid Ultrasound on Addressing Cardiovascular Risk in Patients With Arthritis
Impact of Nurse-led Programme With Carotid Ultrasound on Addressing Cardiovascular Risk in Patients With Arthritis
Elevated CVD risk is a significant public health problem that contributes greatly to the
 increased morbidity and shortened lifespan of individuals with RA and PsA. Over the past
 decades, there has been great progress into the understanding of the severity of CVD risk in
 these patients but these risk factors are not well managed. The development of the high-risk
 strategy is therefore necessary, with more intensive therapy reserved for patients identified
 as high-risk, e.g. because they have high-risk FRS. However, these risk scores
 under-estimated CV risk in patients with RA and PsA. An intermediate approach is to use
 quantification of preclinical vascular disease to further identify high-risk patients.
 Results from this study will provide clinical implications in terms of detecting and managing
 cardiovascular morbidity in patients with RA and PsA.
Objectives This study investigates the impact of a nurse-led programme on cardiovascular (CV)
 risk screening with and without carotid ultrasound for carotid plaque on CV risk factor
 control in asymptomatic rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients.

 Hypothesis The investigators hypothesize that CV risk stratification and management in RA and
 PsA may be improved by incorporation of carotid ultrasound to assess for carotid plaque.
Inclusion Criteria:

 -  Patients with RA fulfilled the 2010 ACR/EULAR classification criteria or PsA fulfilled
 the Classification of Psoriatic Arthritis (CASPAR) criteria

 -  aged between 18 and 75 will be recruited.

 Exclusion Criteria:

 -  had a history of overt CVD (ie, symptomatic coronary artery disease [CAD] or ischemic
 stroke or transient ischemic attack or peripheral vascular disease)

 -  had significant co-morbidities including severe renal impairment or severe deranged
 liver function

 -  female of childbearing potential who are unwilling to use adequate contraception,
 pregnant or breastfeeding women

 -  patients who are already taking lipid lowering therapy.