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Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre
Marta Gruca1, Krzysztof Orczyk2, Justyna Zamojska1
1Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 91-738 Łódź, Poland.
Insights
Carotid intima-media thickness (cIMT) may help screen for cardiovascular disease in children with juvenile idiopathic arthritis (JIA). Further research is needed to confirm its routine use in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Health
- Medical Diagnostics
Background:
- Children with juvenile idiopathic arthritis (JIA) face increased adult cardiovascular disease risk.
- Lifestyle factors like smoking, inactivity, and obesity may exacerbate this risk, especially during the COVID-19 pandemic.
- Reliable prognostic markers for cardiovascular events in JIA are lacking.
Purpose of the Study:
- To evaluate the utility of carotid intima-media thickness (cIMT) measurement as a prognostic marker for cardiovascular risk in children with JIA.
- To explore the correlation between cIMT and other cardiovascular risk factors in JIA patients.
Main Methods:
- Carotid intima-media thickness (cIMT) was measured in 45 children with JIA and compared to 37 healthy controls.
- Analysis included anthropometric data, laboratory tests (e.g., ESR), and lifestyle surveys.
- Data collection occurred during the COVID-19 pandemic, noting lifestyle changes.
Main Results:
- Four JIA patients exhibited cIMT above the 94th percentile.
- A positive correlation was observed between erythrocyte sedimentation rate (ESR) and right carotid artery cIMT percentiles.
- Passive smoking independently increased cardiovascular risk; increased screen time correlated with reduced physical activity during the pandemic.
Conclusions:
- Carotid intima-media thickness (cIMT) shows promise as a future screening tool for cardiovascular risk in pediatric JIA patients.
- Further studies with larger cohorts are required to establish cIMT's routine clinical applicability in JIA management.
Background:
Children diagnosed with juvenile idiopathic arthritis (JIA) are thought to be more likely to develop cardiovascular disease in adulthood. The factors modulating the cardiovascular risk, involving exposure to secondhand smoking, sedentary lifestyle and abnormal body mass index, might have had a stronger impact during the COVID-19 pandemic. The lack of reliable prognostic markers for a higher probability of cardiovascular events might be solved by carotid intima-media thickness (cIMT) measurement. The paramount goal of the study was to assess its usefulness in JIA patients.
Materials And Methods:
The results of cIMT measured by a single physician in 45 children diagnosed with JIA were compared to 37 age- and sex-matched healthy counterparts. The analysis also involved anthropometric parameters, laboratory tests, and a survey regarding lifestyle-related factors.
Results:
Four JIA patients appeared to have cIMT above the 94th percentile. A positive correlation between erythrocytes sedimentation rate (ESR) and right carotid artery percentiles was found. Passive smoking increased the cardiovascular risk regardless of JIA. Doubling the daily screen time during the pandemic led to a significant reduction in children's physical activity. However, the number of enrolled subjects was not enough to make significant recommendations.
Conclusions:
cIMT measurements remain an interesting perspective for future cardiovascular screening of children with JIA. It has yet to be determined whether it should be considered in all JIA patients on a reliable basis.
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