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Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific

Hitomi Kobayashi1, Jon T Giles, Joseph F Polak

  • 1Divisions of Rheumatology, Cardiology, and Immunogenetics, Department of Medicine, and Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.

The Journal of Rheumatology
|January 30, 2010
PubMed

Insights

Rheumatoid arthritis (RA) is linked to increased carotid atherosclerosis, particularly in the internal carotid artery bulb. This study found higher intima-media thickness and plaque prevalence in RA patients, highlighting the need for specific assessments in RA cardiovascular risk evaluation.

Area of Science:

  • Cardiovascular disease research
  • Rheumatology
  • Atherosclerosis imaging

Background:

  • Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality.
  • Previous studies on RA and carotid atherosclerosis have shown inconsistent findings.
  • Carotid intima-media thickness (IMT) and plaque prevalence are key indicators of atherosclerosis.

Purpose of the Study:

  • To compare carotid intima-media thickness (IMT) and plaque prevalence between individuals with and without rheumatoid arthritis (RA).
  • To investigate the association of RA with atherosclerosis in the common carotid artery (CCA) and the proximal internal carotid artery (bulb-ICA).

Main Methods:

  • B-mode ultrasonography was used to assess IMT and plaque in the CCA and bulb-ICA of RA patients and non-RA controls.
  • Linear regression modeled the association of RA status with IMT, while logistic regression assessed the association with plaque.
  • 195 RA patients were compared to 198 non-RA controls from the Multi-Ethnic Study of Atherosclerosis.

Main Results:

  • RA patients exhibited significantly higher mean adjusted bulb-ICA-IMT compared to controls (1.16 vs 1.02 mm).
  • The odds of carotid plaque were significantly increased in RA participants (OR 2.41).
  • While CCA-IMT did not differ significantly, the bulb-ICA showed increased atherosclerosis severity and prevalence in RA.

Conclusions:

  • Rheumatoid arthritis is associated with increased prevalence and severity of atherosclerosis specifically in the bulb-ICA, not the CCA.
  • These findings suggest that bulb-ICA assessment is crucial for future studies evaluating cardiovascular risk in RA patients.
  • The study highlights the importance of targeted carotid artery imaging in managing cardiovascular complications of RA.
Abstract

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