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THU0044 Different type of carotid arterial wall remodeling in rheumatoid arthritis as compared to healthy subjects
  1. A.M. van Sijl1,2,3,
  2. K. van den Hurk4,
  3. M.J. Peters5,
  4. V.P. van Halm6,
  5. G. Nijpels7,
  6. C.D. Stehouwer8,
  7. Y.M. Smulders5,
  8. A.E. Voskuyl2,
  9. J.M. Dekker9,
  10. M.T. Nurmohamed1,2,5
  1. 1Rheumatology, Jan van Breemen Research Institute - Reade
  2. 2Rheumatology
  3. 3Internal medicine and institute for Cardiovascular Research (ICaR), VU University Medical Center
  4. 4Epidemiology and Biostatistics, EMGO institute for Health and Care Research, VU University Medical Center
  5. 5Internal medicine, Institute for Cardiovascular Research (ICaR), VU University Medical Center
  6. 6Cardiology, Academic Medical Center
  7. 7General Practice, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam
  8. 8Internal medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht
  9. 9Epidemiology and Biostatistics, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands

Abstract

Background Rheumatoid arthritis (RA) is associated with an increased cardiovascular (CV) risk, but mechanisms explaining this increased risk have not been fully elucidated. Arteries react on hemodynamic changes by arterial remodeling.

Objectives We investigated whether arterial remodeling is different in RA as compared to control subjects.

Methods 96 RA-patients and 274 healthy subjects were investigated cross-sectionally in two cohorts. B-mode carotid ultrasonography was used to investigate arterial wall parameters, including carotid intima-media thickness (cIMT), inter-adventitial diameter (IAD) and lumen diameter (LD), calculated as IAD – (2 × cIMT). Using linear regression, the association between presence of RA and arterial wall parameters was assessed.

Results RA was associated with a 0.57 mm (9.3%) greater LD. IAD was 0.61 mm (7.8%) higher in RA. cIMT did not differ between RA patients and healthy subjects, resulting in a 4.4% greater wall-to-lumen ratio (ratio of IAD to cIMT, an indicator of outward remodeling) in RA. Associations remained similar after exclusion of patients with prior CV disease and after adjustment for demographic factors and CV risk factors. In RA, disability index and current use of prednisone were significantly associated with a greater wall-to-lumen ratio.

Conclusions RA is associated with outward arterial remodelling, which is relevant because this is associated with plaque instability and rupture.

Disclosure of Interest None Declared

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