CardiovascularCarotid Intima-Media Thickness Predicts the Development of Cardiovascular Events in Patients with Rheumatoid Arthritis
Section snippets
Patients
The cohort assessed in this study constituted a series of RA patients attending hospital outpatient clinics and seen at Hospital Xeral-Calde, Lugo, Northwest Spain in May 2001. Clinical information about these patients has been reported elsewhere (14, 15). RA patients seen during the period of recruitment who had hypertension (systolic blood pressure >150 mm Hg and/or diastolic blood pressure >90 mm Hg), diabetes mellitus (fasting overnight venous plasma glucose concentration >110 mg/dL),
Results
Eight (17%) of the 47 patients experienced CV events over the 5-year follow-up period of study. Four (9%) of them had ischemic heart disease, 3 (6%) cerebrovascular accidents, and 1 (2%) peripheral arteriopathy. At the end of the study 3 (6%) patients had died because of CV events.
The main clinical and ultrasonographic differences between RA patients who experienced CV events and those who did not have these complications are shown in Table 1. As expected, patients who had CV events were older.
Discussion
The results from the present study show that carotid artery IMT has a high predictive power for the development of CV events over a 5-years follow-up period in patients with RA. The presence of subclinical atherosclerosis, manifested by increased values of carotid IMT in the this series of patients without clinically evident CV disease at the time of the carotid ultrasonographic study, is consistent with the high rate of silent ischemic heart disease and sudden cardiac death observed in RA
Acknowledgment
This study was supported by a grant from Fondo de Investigaciones Sanitarias PI06-0024 (Spain).
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