Article Text
Abstract
Background The relationship between inflammation and atherosclerosis has been demonstrated, so it is important to identify early markers of the disease. Ultrasound carotid intima-media thickness (CIMT) measurement is a non-invasive, consistent, validated technique used as a marker to identify subclinical arteriosclerotic disease,
The long-term risk of cardiovascular disease in young adult patients with juvenile idiopathic arthritis (JIA) is unclear and there are no risk management guidelines for these patients.
Objectives To assess whether there is an increase in CIMT in the young adult with a history of JIA and to relate CIMT with classic cardiovascular risk factors in these patients.
Methods Observational and cross-sectional study. Follow-up patients from transitional care between 18 and 36 years old, with JIA diagnosis by ILAR classification. Filiations data, anthropometric variables and activity disease scores were collected.
We performed, prior informed consent, CIMT measurement by radiofrequency with Esaote MyLab 70XVG. Three measurements were performed on each carotid artery, according to the protocol of the American Society of Echocardiography.
Results Of the 20 patients, 17 (85%) women and 3 (15%) men. Subtype distribution was 8 (40%) oligoarticular, 1 of them ANA negative; 8 (40%) polyarticular being 4 seropositive and 4 seronegative; 1 systemic (5%); 2 (10%) psoriatic arthropathy and 1 (5%) HLA B27 positive arthritis. 66.7% are with disease modifying drugs (26.7% synthetic and 40% biological), while 33.3% do not have specific treatment.
The main variables studied are described in the attached table (Table 1).
In two previous independent studies conducted by Falaschi and Huang, CIMT was found to be 0.54±0.03 mm and 0.54±0.06 mm in 26 and 38 patients, respectively. From these results a mean and standard deviation of 0.54±0.05 mm were obtained. Using this last result as a control group, we compared it with the results of our series (0.466±0.068), with a significant difference (p<0.001).
In the statistical analysis, using the Rho Spearman, a significant correlation of the CIMT with the time of evolution of the disease in years (r =0.579) and systolic blood pressure (r =0.621) was observed at the level of 0.01 and with C Reactive Proteine (r =0.524) and BMI (r =0.471) at the 0.05 level.
Conclusions The carotid intima-media thickness of patients with JIA were lower than the controls previously described in the literature, so we will complement this study with our population controls.
In addition to classic cardiovascular risk factors such as systolic blood pressure and BMI, there is correlation with the evolution time in years of the disease and CRP, so that in transitional care programs we must the activity of the disease and insist on identification, control and follow-up of the classics factors associated with cardiovascular risk.
Disclosure of Interest None declared