Background Patients with rheumatoid arthritis (RA) and carotid artery plaques (CP) have increased risk of acute coronary syndrome. Statin treatment with low density lipoprotein cholesterol (LDL-c) goal ≤1.8 mmol/L is recommended for the general population in patients with CP.
Objectives Our objective was to evaluate the effect of 18 months intensive statin treatment on CP height in patients with inflammatory joint disease (IJD).
Methods Patients with CP and IJD [RA (n=55), ankylosing spondylitis (n=21) and psoriatic arthritis (n=10)] were treated with rosuvastatin to obtain LDL-c goal. CP height was evaluated by B–mode ultrasound.
Results The mean age was 60.8±8.5 (mean ± SD) and the gender distribution was 52 (60.5%)/34 (39.5%) [female/male]. Compliance of rosuvastatin usage was 97.9 (96.0, 99.4)[median (IQR)]. At baseline, the median number of CP was 1.0 (1-6) (range), with a median height of 1.80 mm (1.60, 2,10) (IQR). Change in CP height after 18 months on rosuvastatin treatment (mean dose 30.7±14.7 mg) was -0.20±0.34 mm (one-sample t-test, p<0.001). Baseline LDL-c was 4.0±0.9 mmol/L and the change in LDL-c was mmol/L -2.3±0.8 mmol/L (one-sample t-test, p<0.001). Mean LDL-c level during 18 months rosuvastatin treatment was 1.7±0.4 mmol/L. Fifty-three patients (61.6%) achieved LDL-c goal. In a linear regression model (age/gender adjusted) the degree of CP height reduction was independent of the LDL-c level exposure during the study period (p=0.36). Attainment of LDL-c ≤1.8 mmol/L or the change in LDL-c level did not influence degree of CP height reduction (p=0.44 and p=0.46, respectively). In a logistic regression model age, gender, blood pressure and use of biologic medication did not contribute to the CP height reduction.
Conclusions Intensive lipid lowering with rosuvastatin induced regression of CP height and reduced LDL-c significantly in patients with IJD. The LDL-c goal attainment, the change in LDL-c or the LDL-c level exposure during the study period did not influence the degree of CP height reduction.
Disclosure of Interest None declared