Background Patients with Rheumatoid Arthritis (RA) have an increased risk of atherosclerosis and cardiovascular disease (CD) when compared with the general population.
Objectives We assessed if the inflammatory burden, the disease activity as well as specific features of the disease correlate with the presence of subclinical atherosclerosis in patients with RA.
Methods A cohort of patients with RA without cardiovascular events was studied in a tertiary University Hospital. Carotid ultrasonography was performed by a MyLab 70 scanner (Esaote; Genoa, Italy), equipped with 7–12 MHz linear transducer and the automated software guided technique radiofrequency – Quality Intima Media Thickness in real-time (QIMT, Esaote, Maastricht, Holland) to determine carotid intima-media thickness (cIMT) and plaques, according to the Mannheim Carotid Intima-Media Thickness Consensus. We analyzed disease duration (>2 years, 2-10, >10 years), rheumatoid Factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA) status, and PCR and ESR. DAS28 and SDAI were calculated. Logistic regression analyses were performed.
Results We assessed 592 patients with RA (456 women/136 men; mean age 59±13 years) without history of cardiovascular events. Among them, 55% and 47% of patients had RF+ and ACPA+ respectively (61% were RF+ and/or ACPA +). The prevalence of plaques was not increased in RF+ and/or ACPA+ patients: OR: 1.02 [0.73-1.43] or in those with erosions on plain radiograph: OR: 1.03 [0.74-1.45]. A significant correlation between the mean CRP values in the last 5 years prior to carotid ultrasound and the cIMT (p=0.012) or the presence of carotid plaques (p=0.006) was found. However, this significant correlation was not observed after adjustment for age and smoking. No correlation between carotid ultrasound and DAS28 and SDAI was found.
Conclusions Our study does not support a correlation between subclinical atherosclerosis assessed by carotid ultrasound and disease duration or specific features of RA.
Disclosure of Interest None declared
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