RESEARCH - RA is an independent risk factor for increased carotid intima-media thickness: impact of anti-inflammatory treatment

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Rheumatology (Oxford). 2010 Mar 5.

Rheumatoid arthritis is an independent risk factor for increased

carotid intima-media thickness: impact of anti-inflammatory treatment.

Ristic GG, Lepic T, Glisic B, Stanisavljevic D, Vojvodic D,

Petronijevic M, Stefanovic D.

Department of Rheumatology and Clinical Immunology, Department of

Neurology, Military Medical Academy, Institute for Medical Statistics,

Belgrade University School of Medicine and Institute for Medical

Research, Military Medical Academy, Belgrade, Serbia.

Objectives. To evaluate the extent of subclinical atherosclerosis in

patients with RA and low cardiovascular risk by measuring intima-media

thickness (IMT) of the carotid arteries and to determine factors

associated with increased IMT.

Methods. IMT was measured by ultrasonography in 42 non-diabetic,

normotensive, female RA patients and 32 matched healthy controls [age

45.3 (10.0) vs 45.2 (9.8) years] at common carotid arteries (CCAs),

carotid bifurcation (BF) and internal carotid arteries (ICAs),

bilaterally. Mean and maximal (max) IMTs were calculated from three

measurements at each site. Clinical work-up included laboratory

analyses, determination of the disease activity and evaluation of

treatment.

Results. RA patients had increased IMT (mm) in comparison with

controls [CCA(max): 0.764 (0.148) vs 0.703 (0.100); CCA(mean): 0.671

(0.119) vs 0.621 (0.085); BF(max): 1.055 (0.184) vs 0.941 (0.161);

BF(mean): 0.889 (0.168) vs 0.804 (0.124); ICA(max): 0.683 (0.108) vs

0.613 (0.093); ICA(mean): 0.577 (0.101) vs 0.535 (0.076)]. Parameters

associated with IMT in RA patients were (correlation at x/6

measurement sites): age (6/6), BMI (2/6), smoking (2/6), RF

concentration (2/6), sedimentation rate (1/6) and duration of MTX +

chloroquine therapy (4/6; inverse correlation). Multivariate

regression analysis revealed that RA is an independent risk factor for

increased IMT. Factors correlating with IMT in the controls were: age

(6/6), BMI (3/6), total cholesterol (5/6), low-density lipoprotein

cholesterol (3/6), total/high-density lipoprotein cholesterol (2/6),

triglycerides (1/6) and glycaemia (4/6).

Conclusion. Despite a favourable risk profile, our female RA patients

had significantly enlarged carotid IMT than controls. RA itself was an

independent risk factor for increased IMT. Impact of chronic

inflammation on atherosclerosis was confirmed by negative correlation

of IMT and duration of anti-inflammatory treatment.

PMID: 20208070

http://www.ncbi.nlm.nih.gov/pubmed/20208070

Not an MD