Prevalence and extent of calcification over aorta, coronary and carotid arteries in patients with rheumatoid arthritis.
OBJECTIVE
To evaluate the prevalence and pattern of arterial calcification in patients with rheumatoid arthritis (RA).


BACKGROUND
Patients with RA are prone to premature atherosclerosis; nonetheless the prevalence and extent of atherosclerosis in different vascular beds and their relationship to each other remain unknown.


METHODS
We studied the distribution and extent of arterial calcification in 85 RA patients and 85 age-and sex-matched controls. Arterial calcification as determined by calcium score (CS) were measured using multi-detector computed tomography in thoracic aorta, coronary and carotid arteries.


RESULTS
Compared with controls, RA patients had a significantly higher average CS and prevalence of CS > 0 in aorta, coronary and carotid arteries and overall arteries (all P < 0.05). After adjusting for age and sex, RA patients had a significantly higher relative risk of developing calcification in the aorta [Odds Ratio (OR) = 19.5, 95% Confidence Interval (CI): 8.0-47.6], followed by the carotid arteries (OR = 5.7, 95% CI:1.7-18.7) and coronary arteries (OR = 5.0, 95% CI:2.2-11.1) compared with controls (all P < 0.01). Amongst RA patients aged >60, 90% had diffuse arterial calcification, especially over the thoracic aorta, compared with 55% of controls who had arterial calcification clustered in the coronary arteries (P < 0.05). RA patients with total CS > 0 were older with a higher urea level and C-reactive protein than those without arterial calcification, no factor was found to be independently predictive for arterial calcification (all P > 0.05).


CONCLUSIONS
Our results demonstrated that RA patients had earlier onset, more diffuse arterial calcification over multiple vascular beds and more preferential involvement of thoracic aorta, rather than coronary artery when compared with control.
Wang
S
S
Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong.
Yiu
K-H
KH
Mok
M-Y
MY
Ooi
G C
GC
Khong
P-L
PL
Mak
K-F H
KF
Lau
C-P
CP
Lam
K-F
KF
Lau
C-S
CS
Tse
Hung-Fat
HF
D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014057:Tomography, X-Ray Computed / Q000379:methods