Background Rheumatoid arthritis (RA) is a chronic infammatory disease resulting in disability as well as joint dam‑
age. Early diagnosis and treatment are crucial for improving outcomes. RA patients have a twofold elevated risk
of cardiovascular disease (CVD) development compared to the general population. Carotid ultrasound is a noninva‑
sive imaging modality that can detect early signs of atherosclerosis and plaque buildup in the carotid arteries, which
are strongly associated with CVD risk. Galectin-3 (Gal-3), a protein involved in infammation and fbrosis, is suggested
as one of the potential RA markers. Despite the growing interest in galectin-3 as a biomarker for CVD, few studies have
investigated its role in RA patients. To our knowledge, only two studies have examined the correlation between galec‑
tin-3 and CVD in RA patients, and they have yielded conficting results. This study aimed to determine the serum level
of Gal-3 as well as its correlation with carotid ultrasound assessment for cardiovascular involvement in RA patients.
Results RA cases demonstrated substantially elevated Gal-3 levels than controls (P < 0.001), and a 3.38 pg/mL cut-of
value was proven to be an excellent predictor of RA diagnosis (AUC, 0.98). Gal-3 levels were proven to be positively
associated with DAS-28, Larsen score, and carotid intima-media thickness (CIMT) (P-value 0.006, 0.026, < 0.001, respec‑
tively). A positive association was also detected between right (RT) and left (LT) CIMT and disease duration (P-values
of 0.040 and 0.042, respectively).
Conclusions Gal-3 is a biomarker for RA that is not only associated with activity and severity of the disease but it
is also related to the chronicity of the disease and is a predictor of cardiovascular comorbidity