title: Single measurements of C-reactive protein and disease activity scores are not predictors of carotid atherosclerosis in rheumatoid arthritis patients.
abstract: BACKGROUND
  Although inflammation has a defined role in the pathogenesis of atherosclerosis, the link between rheumatoid arthritis (RA) parameters of disease activity and atherosclerotic findings are not defined.
  
  
  OBJECTIVE
  To investigate the association between subclinical carotid atherosclerosis and clinical/laboratorial parameters of RA systemic inflammatory activity.
  
  
  METHODS
  Seventy-one RA patients were consecutively selected and compared to 53 healthy controls. Smoking, diabetes and hypertension were excluded, as well as the use of statins or fibrates. B-mode carotid ultrasound was performed in all subjects. CRP, ESR and fibrinogen were determined in both groups. Clinical assessment of RA activity included DAS 28 and SDAI. Correlation between plaques and intima-media thickness (IMT) of common carotid arteries and inflammatory parameters was evaluated.
  
  
  RESULTS
  Carotid plaques were more prevalent in RA patients than in controls (14.1% vs. 1.9 %, p=0.02) and marginally increased IMT was observed (0.72 +/- 0.17 vs. 0.67 +/- 0.15 mm, p=0.07). RA patients with plaques had older age (p=0.001) and increased IMT (p<0.001), but low SDAI (p=0.025) compared to those without plaques. RA patients with plaques had also longer disease duration, although this difference did not reach statistical significance (p=0.06). No significant correlations were found between IMT and ESR (p=0.80), CRP (p=0.75), fibrinogen (p=0.94), HAQ (p=0.89) and DAS 28 (p=0.13).
  
  
  CONCLUSIONS
  Carotid atherosclerosis is more frequently detected in RA but its prevalence was not correlated with isolated inflammatory markers measurement or noncumulative activity scores. These findings reinforce the need to evaluate subclinical atherosclerosis in RA patients, and to find predictors of atherosclerotic lesions.
authors.affiliation: Rheumatology Division, University of Santa Catarina, Santa Catarina - Brazil. ivaniop@matrix.com.br
authors.forename: Ivânio Alves
authors.initials: IA
authors.lastname: Pereira
authors.forename: Ieda M M
authors.initials: IM
authors.lastname: Laurindo
authors.forename: Adriana F
authors.initials: AF
authors.lastname: Zimmermann
authors.forename: Gláucio R
authors.initials: GR
authors.lastname: Werner Castro
authors.forename: Filipe
authors.initials: F
authors.lastname: Mello
authors.forename: Eduardo Ferreira
authors.initials: EF
authors.lastname: Borba
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D002097:C-Reactive Protein / Q000032:analysis*; D002340:Carotid Artery Diseases / Q000097:blood* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D002097:C-Reactive Protein