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Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study

Martin I Wah-Suarez1, Dionicio A Galarza-Delgado2, Jose R Azpiri-Lopez3

  • 1Internal Medicine Department, University Hospital Dr.Jose Eleuterio Gonzalez UANL, Monterrey, Mexico.

International Journal of Rheumatic Diseases
|September 1, 2018
PubMed

Insights

Rheumatoid arthritis patients show significantly higher rates of subclinical atherosclerosis, detected via carotid ultrasound (US) measures of intima-media thickness (cIMT) and plaque (CP), compared to controls. These findings highlight increased cardiovascular risk in RA.

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Imaging

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with an increased risk of cardiovascular disease (CVD).
  • Subclinical atherosclerosis, detectable through carotid ultrasound (US), is a key indicator of CVD risk.
  • Evaluating carotid intima-media thickness (cIMT) and carotid plaque (CP) can identify asymptomatic atherosclerosis.

Purpose of the Study:

  • To assess carotid US characteristics, specifically cIMT and CP, in rheumatoid arthritis (RA) patients compared to a control group.
  • To investigate the prevalence and features of subclinical atherosclerosis in a Mexican-mestizo population with RA.

Main Methods:

  • A prospective, cross-sectional, observational study comparing RA patients and matched controls.
  • Carotid US was performed by blinded radiologists to measure cIMT and identify CP.
  • Statistical analysis compared carotid US findings between RA patients and controls.

Main Results:

  • The study included 103 RA patients and 106 controls.
  • Bilateral carotid plaque (CP) was more than twice as common in RA patients (15.5%) versus controls (6.6%).
  • Increased cIMT was significantly more prevalent in RA patients on both the right (37.9% vs 15.1%) and left (43.7% vs 19.8%) sides.

Conclusions:

  • Rheumatoid arthritis patients exhibit greater subclinical atherosclerosis, as evidenced by carotid US measurements of cIMT and CP.
  • RA patients with subclinical atherosclerotic disease tend to present with more heterogeneous plaque characteristics.

Keywords:
cardiovascular prediction algorithmcarotid intima-media thicknesscarotid plaquecarotid ultrasoundrheumatoid arthritis

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