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Subclinical atherosclerosis in rheumatoid arthritis in India

Sundeep Grover1, Ramanand Prasad Sinha, Uttam Singh

  • 1Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

The Journal of Rheumatology
|February 9, 2006
PubMed

Insights

Subclinical atherosclerosis, indicated by increased carotid intima-media thickness (IMT), affects one-third of Indian rheumatoid arthritis (RA) patients. Age and tender joint count predict abnormal IMT in RA.

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Ultrasound

Background:

  • Rheumatoid arthritis (RA) patients exhibit elevated cardiovascular morbidity and mortality.
  • Indian populations face a heightened risk of early-onset and severe atherosclerotic coronary artery disease.
  • Carotid intima-media thickness (IMT) measured via ultrasound is a recognized surrogate marker for atherosclerosis.

Purpose of the Study:

  • To investigate the prevalence of subclinical atherosclerosis in Indian patients diagnosed with rheumatoid arthritis.
  • To assess common carotid intima-media thickness (CCA IMT) as a marker for atherosclerosis in RA patients.
  • To identify predictors of abnormal CCA IMT in this cohort.

Main Methods:

  • Common carotid intima-media thickness (CCA IMT) was measured using ultrasound in 57 RA patients and 45 controls.
  • Abnormal IMT was defined as mean CCA IMT exceeding the mean + 2 SD of the control group.
  • Traditional cardiovascular risk factors were excluded; logistic regression identified predictors of abnormal IMT.

Main Results:

  • Nineteen RA patients (33.3%) presented with abnormal IMT, compared to 2 controls (4.44%).
  • RA patients showed significantly higher mean CCA IMT (0.558 ± 0.137 mm) versus controls (0.416 ± 0.002 mm; p < 0.0001).
  • Age (≥42 years), disease duration (≥6 years), and tender joint count (≥5) predicted abnormal CCA IMT.

Conclusions:

  • Subclinical atherosclerosis is prevalent in one-third of Indian rheumatoid arthritis patients.
  • Age and tender joint count emerged as independent predictors of abnormal CCA IMT.
  • These findings highlight the increased cardiovascular risk in RA patients and the utility of CCA IMT assessment.
Abstract

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