title: Early atherosclerosis in rheumatoid arthritis: effects of smoking on thickness of the carotid artery intima media.
abstract: This study was designed to compare intima media thickness (IMT) of the carotid arteries among rheumatoid arthritis (RA) patients and controls and to determine whether disease-associated characteristics, smoking, and other classic risk factors for atherosclerosis are associated with IMT values. IMT was measured in the carotid arteries of 101 RA patients and 75 control subjects. The IMT was evaluated in the common carotid (CC), carotid bifurcation (BI), and internal carotid (IC). Eight IMT values were calculated including four mean and four maximal values of CC, BI, IC, and carotid artery (C). The following data were obtained for every patient: age, sex, body mass index (BMI), presence of erosions, extra-articular manifestations, rheumatoid factor, medications, hypertension, hypercholesterolemia, diabetes mellitus, smoking status, daily number of cigarettes, number of smoking years, family history of cardiovascular diseases (CVD), and erythrocyte sedimentation rate (ESR) levels. RA patients had significantly higher mean-BI IMT than controls (1.02 mm vs. 0.89 mm; P < 0.01), higher incidence of increased mean-BI IMT and max-BI IMT, but lower incidence of increased max-IC IMT than controls. Factors significantly associated with IMT in the controls were age, BMI, and hypertension, whereas factors significantly associated with IMT in RA patients were age and smoking status. Mean carotid IMT was associated with all characteristics related to smoking in RA patients. Current smokers had higher mean carotid IMT and internal carotid artery IMT than former smokers. RA is associated with higher carotid artery bifurcation IMT. The profile of factors associated with IMT values is different between RA patients and controls. Smoking is an important factor augmenting early atherosclerosis in RA patients.
authors.affiliation: Section of Internal Medicine and Oncological Sciences, Center for the Study of Rheumatic Diseases, University of Perugia, Perugia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gerli
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Sherer
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vaudo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.forename: Boris
authors.initials: B
authors.lastname: Gilburd
authors.forename: Andrea
authors.initials: A
authors.lastname: Giordano
authors.forename: Elena Bartoloni
authors.initials: EB
authors.lastname: Bocci
authors.forename: Rosita
authors.initials: R
authors.lastname: Allegrucci
authors.forename: Simona
authors.initials: S
authors.lastname: Marchesi
authors.forename: Elmo
authors.initials: E
authors.lastname: Mannarino
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D050197:Atherosclerosis / Q000209:etiology*; D002339:Carotid Arteries / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000473:pathology*; D017539:Tunica Intima / Q000473:pathology*