Background Rheumatoid arthritis (RA) is the most common chronic inflammatory condition and is characterized by an increase risk in cardiovascular (CV) disease. Carotid intima-media thickness (cIMT) is a surrogate marker of CV disease and many studies have evaluated the relationship between cIMT and RA disease activity with contradictory results.
Objectives To evaluate in RA patients the association between both cIMT and carotid plaque presence and clinical RA features and analytical measurements.
Methods We selected 214 RA patients according to the American College of Rheumatology criteria. Conventional clinical evaluation and analytical measurements were performed, including a standard lipid profile. We used My Lab 50 X-Vision sonograph to measure cIMT and atherosclerotic plaque presence
Results No differences between men and women regarding age, body mass index, glycaemia, LDL-C and TG were observed. However, men had a significantly higher waist circumference, systolic and diastolic BP and lower levels of HDLc. On the other hand, women had significantly higher values of DAS28 (3.7 vs 2.99), HAQ, and VSG with no differences in other inflammatory variables (rheumatoid factor, ACPA, CRP or fibrinogen). Moreover, 74% of patients had pathological cIMT without gender differences and 43% had plaque presence in the carotid artery with a significant higher percentage in men (57%) than women (36%). Overall, men had significantly higher cIMT (0.678 vs 0.627 mm) but when disease activity (DAS28) was considered, we observed that such difference was due to patients that were in remission or in low activity. Men and women with moderate and high disease activity had no statistical differences in cIMT. Furthermore, across women cIMT was significantly higher in those with high disease activity compared with remission. This effect was not observed in men. Multivariate linear regression with cIMT showed a significant interaction between age and gender, so that the effect of age on cIMT was significantly more pronounced in men than in women.
Conclusions We have described that in our RA cohort, disease activity measured with DAS28 and age are differentially associated with cIMT in men and women. Our results could explain the contradictory results published in the literature and it can be justified by a higher incidence of RA in women and by the hormonal-genetic status.
Disclosure of Interest None declared