Subclinical atherosclerosis in rheumatoid arthritis: a case cohort analysis from ELSA-Brasil

This study evaluated prevalence, incidence, and progression of carotid intima-media thickness (cIMT) and carotid artery plaques (CAP) in rheumatoid arthritis (RA) patients compared with controls during 8 years of follow-up. A case-cohort analysis of data from the ELSA-Brasil cohort was conducted, with cIMT and CAP measured by carotid ultrasound at baseline and follow-up. Linear regression was used to estimate cIMT mean and progression (ΔcIMT). Logistic regression was used to estimate odds ratios (OR) for elevated cIMT (≥75th percentile), CAP prevalence, incidence, and progression. Models were adjusted for sociodemographic and cardiovascular risk factors, excluding participants with prior cardiovascular disease. A total of 1,289 participants (188 RA, 1,101 controls) were included in the cIMT analysis and 585 (93 RA, 492 controls) in the CAP analysis. RA was not associated with baseline cIMT (β=0.00; 95%CI: -0.02-0.02; P=0.930), high cIMT (OR=1.04; 95%CI: 0.69-1.57; P=0.864), or ΔcIMT (β=0.00; 95%CI: -0.01-0.02; P=0.688). Incidence of elevated cIMT showed a non-significant trend toward higher risk in RA (OR=2.01; 95%CI: 0.88-4.59; P=0.098). No associations were found for CAP prevalence at baseline (OR=1.64; 95%CI: 0.92-2.91; P=0.090), prevalence at follow-up (OR=0.75; 95%CI: 0.41-1.36; P=0.342), incidence (OR=0.78; 95%CI: 0.37-1.63; P=0.508), or progression (β=-0.33; 95%CI: -0.72-0.07; P=0.102). This study found no independent association between RA and cIMT or CAP.