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Subclinical femoral atheromatosis in rheumatoid arthritis: comparable prevalence to diabetes mellitus in a case-control study
  1. Athanase Protogerou1,
  2. Evangelia Zampeli1,
  3. Nikos Tentolouris1,
  4. Kostas Makrilakis1,
  5. George Kitas2,
  6. Petros P Sfikakis1
  1. 1First Department of Propaedeutic and Internal Medicine, Laikon Hospital, Athens, Greece
  2. 2The Dudley Group of Hospitals NHS Foundation Trust, Dudley, and Arthritis Research Campaign Epidemiology Unit, University of Manchester, Manchester, UK
  1. Correspondence to Petros P Sfikakis, First Department of Propaedeutic and Internal Medicine, Medical School, University of Athens, ‘Laikon’ Hospital, Ag. Thoma, 17, 11527 Athens, Greece; psfikakis{at}


Objective Rheumatoid arthritis (RA) is associated with increased coronary artery disease (CAD) and subclinical carotid atheromatosis, reportedly to equal diabetes mellitus (DM). The presence of atheromatic plaques in femoral arteries of RA patients without DM was compared with with DM patients.

Methods Femoral plaques were recorded in 30 (17 men, age 43.0±12 years, disease duration 9.9±7.1 years) and 60 older RA patients (27 men, age 63.0±7.1 years, disease duration 11.4±7.9 years) matched 1:1 for age, gender and disease duration with DM types 1 and 2 patients, respectively. All were asymptomatic and free of CAD.

Results The number of femoral plaques per patient in either RA subgroup was comparable with DM (0.64±0.82 vs 0.77±0.89 in total respective populations, p=0.340); percentages of patients with femoral plaques were also comparable (RA vs DM type 1 20% and 13%, respectively; RA vs DM type 2 58% and 66%, respectively). Hypertension and dyslipidaemia were significantly more frequent in both DM groups than RA groups.

Conclusions Subclinical femoral atheromatosis in RA is analogous to DM, further confirming the territorial unrestricted acceleration of the atheromatic process in these patients. Cardiovascular risk stratification based on both carotid and femoral plaque detection in RA should be addressed prospectively.

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  • Competing interests None.

  • Ethics approval The study was approved by the Ethical/Scientific Committee of Laikon Hospital (reference no 664).

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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