Background Cardiovascular diseases (CVD) have recently been recognized as important causes of mortality in patients with rheumatoid arthritis (RA). One aim of the prospective TOMORROW (TOtal Management Of Risk factors in Rheumatoid arthritis patients to lOWer morbidity and mortality; clinical trial registration number: UMIN000003876) study that started in 2010 was to determine associations between atherosclerosis and RA using carotid ultrasound.
Methods Atherosclerosis was assessed using carotid ultrasound in 402 individuals (mean age 59.0) comprising 200 patients with RA and 202 healthy volunteers (HV). The presence of carotid atherosclerotic plaques and plaque scores defined as the sum of the thickness of carotid plaques were evaluated.
Results The prevalence of carotid plaques and plaque scores was significantly greater in patients with RA than in controls (47% vs. 37%, p<0.05 and 1.74 vs. 1.02, p<0.01, respectively) Multivariate logistic regression analyses showed that a plaque score of >2.0 was associated with RA after adjustment for atherosclerotic risk factors (age, gender, smoking, hypertension, diabetes mellitus and LDL-cholesterol) (OR 1.74, p<0.05; Table 1). Steinbrocker class remained associated with plaque score (β = -0.148, P=0.03) in patients with RA after adjustment for risk factors.
Conclusions Atherosclerosis is independently associated with RA. These observations might at least partly explain the high risk for atherosclerosis and cardiovascular disease among patients with RA.
Disclosure of Interest Y. Sugioka: None Declared, T. Koike Grant/Research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, K. Mamoto: None Declared, T. Okano: None Declared, M. Tada: None Declared, S. Wakitani: None Declared, H. Nakamura Grant/Research support from: Chugai Pharmaceutical, Astellas Pharma Inc.,Janssen Pharmaceutica, GlaxoSmithKline, Pfizer Inc. and Daiichi Sankyo, INC., Speakers Bureau: Ono Pharmaceutical