Table 1

Studies on subclinical cardiovascular changes near the onset of rheumatoid arthritis (RA)

Author, year (ref)RA diagnosisRA patientsControlsTiming of endpoint observationEvaluated parameterResults
Pre-atherosclerotic changes
Chatterjee Adhikari, 201222ACR 19873535Disease duration <1 yearBrachial artery flow-mediated dilationBrachial artery vasodilation  response was lower among RA patients
van Eijk, 201123ACR 1987 criteria and CRP ≤20 mg/l1515Median symptom duration 5 months (IQR 4–12)Microvascular endothelium-dependent and endothelium-independent vasodilationNo difference in skin microvascular function
Foster, 201024Referrals to an early arthritis clinic1848 healthy and 25 type 2 diabetic hypertensive controlsSymptoms >1 month, median 2 months (IQR 1.2–3.0)Microvascular endothelium-dependent and endothelium-independent vasodilation and brachial artery flow-/nitrate-mediated dilationBoth micro- and macrovascular endothelial function were preserved but endothelium-independent responses were abnormal. In contrast, some molecular markers of endothelial damage were raised
Sodergren, 201025ACR 198779 at baseline, 27 in follow-up44Symptoms <12 months at baseline, follow-up after 18 monthsBrachial artery flow-mediated dilationNo significant differences at first evaluation or in follow-up
Turiel, 201026ACR 19872025RA duration <1 yr at inclusion, follow-up after 18 months of DMARDsCoronary flow reserveCoronary flow reserve improved after 18 mo of treatment
Turiel, 200927ACR 19872525Disease duration <1 yearCoronary flow reserveCoronary flow reserve was reduced compared with controls
Hannawi, 200928ACR 19872020RA duration <1 year at inclusion, follow-up after 1 year of DMARD treatmentBrachial artery flow-/nitrate-mediated dilationRA patients had lower vasodilatory responses at baseline. A significant improvement after 1 year of anti-inflammatory therapy
Bergholm, 200229RA patients and high systemic inflammation1033RA duration <18 months, follow-up after 6 months of anti-inflammatory therapyBrachial artery flow-/nitrate-mediated dilationVasodilatory responses in RA patients were impaired at baseline but normal after 6 months of anti-inflammatory therapy
Atherosclerosis
Chatterjee Adhikari, 201222ACR 19873535Disease duration 1 yearCarotid IMTCarotid IMT was greater than in controls
Ahmed, 201030ACR 19874040Symptoms <12 monthsCarotid IMT, carotid plaqueEarly RA patients had higher carotid IMT values and more plaques
Sodergren, 201025ACR 198779 at baseline, 27 in follow-up44Symptoms <12 months at baseline, follow-up after 18 monthsCarotid IMTNo significant differences at first evaluation. In the follow-up there was an increase in IMT
Turiel, 201026ACR 19872025RA duration <1 year at inclusion, follow-up after 18 months of DMARD treatmentCarotid IMTCarotid IMT levels did not change after 18 months of treatment
Turiel, 200927ACR 19872525Disease duration <1 yearCarotid IMTCarotid IMT was greater than in controls
 Georgiadis, 200831ACR 19874045RA duration <1 year at inclusion, follow-up after 1 year of DMARDs treatmentCarotid IMT, carotid plaqueSignificantly elevated IMT but no increase in prevalence of plaques at baseline. After 1 year of therapy a decrease in IMT was noted
Hannawi, 200732ACR 19874040Disease duration 1 yearCarotid IMT, carotid plaqueIMT statistically higher and statistically increased prevalence of atherosclerotic plaques
Chung, 200533ACR 198770 early RA, 71 RA86RA duration was <5 years for early RA patients and >10 years for established RACoronary artery calcificationCoronary calcification not increased in early RA but in established RA
Park, 200234ACR 19875353RA duration either <1 year or moreCarotid IMTIMT was 0.68±0.14 mm in controls, 0.72±0.03 mm in early RA, and 0.78±0.01 mm in later RA. All studied patients were postmenopausal women
  • ACR, American College of Rheumatology; CRP, C-reactive protein; DMARD, disease-modifying anti-rheumatic drug; IMT, intima-media thickness; RA, rheumatoid arthritis.