Do carotid artery diameters manifest early evidence of atherosclerosis in women with rheumatoid arthritis?
OBJECTIVE
Given the high incidence of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA), we examined the associations between RA diagnosis and characteristics and evidence of carotid atherosclerosis. We take a unique approach by evaluating lumen and interadventitial diameters in addition to intima-media thickness and plaque.


METHODS
Ninety-three women with RA were matched with 93 healthy women by age, race, and menopause status. In cross-sectional analyses, we compared common carotid artery measures between groups and examined their relationships with measures of RA severity and activity.


RESULTS
Mean age was 53.3 years, and median RA duration was 14 years. Lumen diameter in patients was significantly greater than in healthy women (5.50 vs. 5.19 mm, p < 0.001), as was interadventitial diameter (6.92 vs. 6.61 mm, p < 0.001). Having RA also was independently associated with greater lumen (beta = 0.256, p < 0.01) and interadventitial (beta = 0.261, p < 0.01) diameters, after controlling for cardiovascular risk factors and intima-media thickness. Carotid intima-media thickness (0.70 vs. 0.71 mm) was similar, and the prevalence of carotid plaque in patients (21%) was higher but not statistically different from healthy women (15%). In patients with RA, we found positive associations between methotrexate dose and interadventitial diameter, between hypothyroidism and intima-media thickness, and between hypothyroidism and soluble endothelial adhesion molecule and plaque, independent of cardiovascular risk factors.


CONCLUSIONS
Women with RA have increased carotid artery diameters compared with healthy women. This may reflect premature vascular aging and may be an early indicator of increased cardiovascular risk.
Schott
Laura L
LL
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. schottll@upmc.edu
Kao
Amy H
AH
Cunningham
Amy
A
Wildman
Rachel P
RP
Kuller
Lewis H
LH
Sutton-Tyrrell
Kim
K
Wasko
Mary Chester M
MC
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D015415:Biomarkers; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010414:Pennsylvania; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D016387:Women's Health
D015415:Biomarkers