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SAT0137 Carotid intima-media thickness and atherosclerotic plaque in patients with reactive and rheumatoid arthritis
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  1. H. Palhuyeva1,
  2. A. Litviakov1,
  3. N. Podolinskaya1
  1. 1Internal desiases, Vitebsk state medical university, Vitebsk, Belarus

Abstract

Background: It is well-known that the leading cause of premature mortality in patients with rheumatoid arthritis (RA) is cardiovascular disease, myocardial infarction, heat failure, stroke.1,2 Another important group of rheumatic diseases that attract the attention in connection with possible proatherogenic effects are the seronegative spondyloarthropathies. Reactive arthritis (ReA) may involves the cardiovascular system, aortitis, myocarditis, pericarditis.3,4

Objectives: to estimate atherosclerotic changes of arteries in patients with RA and ReA, to confront the revealed changes with clinical features of joint pathology, activity of inflammatory process.

Methods: We included 75 patients with RA (age 38,7±7,4, disease duration 8,3±5,4), 41 patients with chronic ReA (age 35,8±7,2 disease duration 6,4±4,5) and 29 healthy subjects, matched for age and gender, without a history of CVD. An ultrasound investigation of the arterial vassal with measurement of the intima-media thickness (IMT) of carotids was performed.

Results: It has been determined, that in RA group IMT was 0,8 mm (0,7–0,9), compared with 0,6 mm (0,6–0,7) in ReA and 0,6 mm (0,6–0,7) in control group. In RA group IMT positively correlate with the age, duration of disease, Ritchie index, C-reactive protein level. In ReA group disease duration, C-reactive protein level, Ritchie index are not associated with IMT.

In 22 (29,3%) patients with RA we found atherosclerotic plaques lesion in carotids, aorta, and vessels of the lower extremities. Only in 1 (2,4%) patient with PeA we found atherosclerotic plaques. Presence of atherosclerotic plaques associated with RA (c2=8,75, p<0,05). In RA detection of atherosclerotic plaques associated with disease durations (12 years (10–15) in group with plaques and 5 years (3–8) in group without plaques). The presence of atherosclerotic plaques is associated with rheumatoid factor (c2=1,02, p>0,05), and systemic manifestations of RA (c2=15,89, p<0,001).

Conclusions: Patients with RA had an increase thickness of IMT and atherosclerotic plaques, which appear in various vascular regions. Long-term duration of ReA is not associated with development atherosclerotic lesion.

References [1]Han C, et al. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J. Rheumatol2006;33(11):2105–2107.

[2]del Rincon ID, et al. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum2001;44:2737–2745.

[3]Hoogland YT, et al. Coronary artery stenosis in Reiter's syndrome: a complication of aortitis. J. Rheumatol1994:21:757–759.

[4]Hannu T, et al. Cardiac findings of reactive arthritis: an observational echocardiographic study. Rheumatol. Int2002:21:169–72.

Disclosure of Interest: None declared

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