RESEARCH - Inflammation predicts accelerated brachial arterial wall changes in patients with recent onset RA

April 15, 2009

Arthritis Research & Therapy 2009, 11:R51doi:10.1186/ar2668

Published: 6 April 2009

Research article

Suad Hannawi , H Marwick and Ranjeny

Inflammation predicts accelerated brachial arterial wall changes in

patients with recent onset rheumatoid arthritis

Abstract (provisional)

Introduction

Patients with recent onset rheumatoid arthritis (RA) have impaired

brachial artery endothelial function compared to controls matched for

age, sex, and cardiovascular risk factors. The present study examined

endothelium-dependent (flow-mediated dilatation, FMD) and independent

(GTN-mediated dilatation, GMD) structural responses in early RA

patients, and determined progress over 1 year.

Methods

Brachial artery FMD and GMD and carotid intima media thickness (cIMT)

were studied using ultrasound in 20 patients diagnosed with early RA

in whom symptoms had been present for less than 12 months, and in 20

control subjects matched for age, sex and established cardiovascular

risk factors. FMD and GMD were re-assessed after 12 months in RA

patients and the change in each parameter was calculated. Data were

analysed by univariate regression.

Results

Mean FMD and GMD were significantly lower in early RA patients at

baseline than in controls, but each parameter significantly improved

in 1 year. FMD and GMD responses were positively associated with each

other. Patients' age, CRP level and cIMT at baseline and CRP level at

1 year, were negatively associated with change in brachial responses

in 1 year.

Conclusions

Patients with recent onset RA have altered brachial artery responses

signifying both functional and structural abnormalities. However,

early control of inflammation may reduce arterial dysfunction and thus

the tendency for atherosclerotic progression.

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Not an MD

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