Assessment of atherosclerosis by carotid intimomedial thickness in patients with rheumatoid arthritis.
OBJECTIVE
To determine the prevalence of subclinical (asymptomatic) atherosclerosis in patients with rheumatoid arthritis (RA) and to study the variables affecting such an occurrence.


METHODS
Case control study which included 100 patients with RA having disease duration more than 5 years and 100 healthy age and sex matched controls. Cases and controls symptomatic for atherosclerosis or having traditional risk factors for atherosclerosis were excluded. Both cases and controls were subjected to carotid ultrasound examination in addition to detailed history and physical examination.


RESULTS
The study population (both cases and controls) included 94 females and 6 males. The mean age of cases and controls was similar (44.06 +/- 11.32 years and 44.1 +/- 11.52 years). The mean disease duration was 155.04 +/- 48.8 months. The mean carotid intimo-medial thickness (CIMT) of the RA patients (0.519 +/- 0.18 mm) was significantly greater than the controls (0.387 +/- 0.085). Age and disease duration were the only factors found to significantly affect CCIMT. RA patients had higher prevalence of carotid plaques (21%) compared to controls (1%). Erosions on hand radiographs were the only significant predictor of plaques in patients with RA.


CONCLUSIONS
Patients with RA exhibit premature atherosclerosis by way of increased CIMT and carotid plaques when compared to age and sex matched controls.
Mahajan
V
V
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Handa
R
R
Kumar
U
U
Sharma
S
S
Gulati
G
G
Pandey
R M
RM
Lakshmy
R
R
D000328:Adult; D000367:Age Factors; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D016022:Case-Control Studies; D003971:Diastole; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D013599:Systole; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography