Inflammatory burden interacts with conventional cardiovascular risk factors for carotid plaque formation in...

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Medical Imaging

Background:

• Rheumatoid arthritis (RA) patients face higher risks of atherosclerosis and cardiovascular (CV) diseases.
• Inflammatory processes in RA are implicated in accelerated CV disease development.

Purpose of the Study:

• To investigate the role of inflammatory burden in carotid plaque formation in RA patients.
• To assess the relationship between cumulative inflammation and traditional CV risk factors in RA-associated atherosclerosis.

Main Methods:

• Carotid ultrasonography (US) was used to measure intima-media thickness (IMT) and detect plaques in 406 RA patients and 209 controls.
• Erythrocyte Sedimentation Rate (ESR) Area Under the Curve (AUC) quantified cumulative inflammatory burden.
• Multivariate regression analysis identified factors associated with carotid plaque presence.

Main Results:

• RA patients exhibited significantly higher carotid plaque frequency and IMT compared to controls.
• Carotid plaques in RA were associated with disease activity (Tender Joint Count, Swollen Joint Count, DAS), inflammatory markers (ESR, CRP), HAQ score, and CV risk factors.
• Multivariate analysis revealed Tender Joint Count, ESR, and number of CV risk factors as significant predictors of plaque formation.
• ESR AUC and CV risk factors independently and synergistically predicted carotid plaque presence in RA.

Conclusions:

• Cumulative inflammatory burden significantly contributes to carotid atherosclerosis development in RA.
• A synergistic interaction exists between cumulative inflammation and conventional CV risk factors in promoting atherosclerosis in RA patients.
• These findings highlight the importance of managing inflammation to mitigate cardiovascular risk in rheumatoid arthritis.