Taking into account all these considerations, in the present study we aimed to assess, for the first time, the potential implication of the SMAD3 rs17228212 polymorphism in the susceptibility to CV manifestations and its possible association with the presence of subclinical atherosclerosis assessed by the evaluation of carotid intima-media thickness (cIMT) using carotid ultrasonography (US) in RA in a large and well characterized cohort of Spanish RA patients. Here, SMAD3 is linked to atherosclerosis.