Individuals with rheumatoid arthritis (RA) have up to 2x the risk of having a heart attack compared to someone without RA. The goal of this study is to identify biomarkers that can help us do a better job of identifying individuals at risk before they develop symptoms of heart disease and start preventative treatment earlier.

The objective of this study is to test the utility of high sensitivity cardiac troponin (hs-cTn) and coronary artery calcium (CAC) in risk stratifying patients with rheumatoid arthritis (RA) who may benefit from lipid lowering therapy. The population of interest are individuals who would not otherwise be recommended for therapy based on general population risk calculators for heart disease risk.

Inclusion Criteria:

• RA diagnosed by a rheumatologist
• Age 40- 79
• ≥1 ASCVD risk factor including prediabetes, hypertension, BMI >30, current or history of cigarette smoking

Exclusion Criteria:

• Patients on a statin or with a contraindication to statin, on a cholesterol absorption inhibitor, or on a PCSK9 inhibitor
• Patients with diabetes mellitus
• Pregnancy

Adult patients with rheumatoid arthritis, age 40- 79 years, with one cardiovascular risk factor and not on a statin or has a contraindication to statin therapy.

Pending IRB approval.