Background Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. Carotid atherosclerosis is one of its manifestations and can be assessed noninvasively by ultrasound. Systemic inflammation is a risk factor for developing ACVD. Rheumatoid arthritis (RA) and periodontitis (PO) are associated with the development of systemic inflammation and ACVD, however the role of the PO is controversial as potential confounders such as smoking and diabetes are independent risk factors for both PO to ACVD.
Objectives To evaluate whether moderate or severe PO is independently associated with the presence of carotid atherosclerotic disease in patients with RA.
Methods An observational, cross-section study was performed. Patients diagnosed with RA (ACR/EULAR 2010) in ambulatory monitoring were included. We excluded those with known cardiovascular disease (heart attack, stroke, heart failure and valvular disease). All participants underwent a clinical evaluation, laboratory tests, dental evaluation and carotid Doppler ultrasound (measurement of intima-media thickness and detection of atheromatous plaques) according to the recommendations of the American Heart Association. The population was divided into 2 groups (G1: with moderate or severe PO and G2: no PO or mild PO). For the analysis of categorical variables, Chi 2 was used (or Fisher exact correction as necessary) and for continuous variables Student test was applied. In all cases a P value less than 0.05 was considered significant. Multivariate analysis was performed using logistic or linear regression as was applicable for adjusting for sex, age, smoking, and diabetes, among other variables.
Results Seventy two patients with RA were included, mean age 54.8 (±3.6) years, 93.9% female, median time from diagnosis of RA 10.7 (±9.2) years. Thirty-one patients (43.1%) had PO. Fifteen patients (20.8%) belonged to the G2. G2 patients had a trend to older age but did not reach statistical significance (60.7±10.2 vs 53.2±14.3, P=0.054) and higher prevalence of males (20% vs 0%, P<0.001). No statistically significant differences in the prevalence of other risk factors, anthropometric measurements and blood pressure were evident. Table 1 shows the main findings in univariate analysis. G2 patients had a higher prevalence of bilateral carotid plaque and increased maximum EIM. When multivariate analysis adjusting for age, sex, smoking and diabetes were conducted no significant differences between groups for the presence of plaques and intima-media thickness showed up.
Conclusions In this cohort of patients with rheumatoid arthritis, the presence of moderate or severe periodontitis was not associated with the presence of carotid atheromatous lesions.
Disclosure of Interest None declared