Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study.
OBJECTIVE
The extent to which atherosclerosis is accelerated in chronic inflammatory diseases is not established. We compared preclinical atherosclerosis in rheumatoid arthritis with diabetes mellitus, a known coronary heart disease equivalent.


RESULTS
Endothelial function, arterial stiffness, carotid intima-media thickness, and analysis of atheromatous plaques were examined in 84 rheumatoid arthritis patients without cardiovascular disease versus healthy controls matched for age, sex, and traditional cardiovascular disease risk factors, as well as in 48 diabetes patients matched for age, sex, and disease duration with 48 rheumatoid arthritis patients. Rheumatoid arthritis duration associated with arterial stiffening, whereas disease activity associated with carotid plaque vulnerability. All markers of preclinical atherosclerosis were significantly worse in rheumatoid arthritis compared to controls, whereas they did not differ in comparison to diabetes despite a worse cardiovascular risk factor profile in diabetics. Both diseases were associated independently with increased intima-media thickness; rheumatoid arthritis, but not diabetes, was independently associated with endothelial dysfunction.


CONCLUSIONS
Preclinical atherosclerosis appears to be of equal frequency and severity in rheumatoid arthritis and diabetes of similar duration with differential impact of traditional risk factors and systemic inflammation. Cardiovascular disease risk factors in rheumatoid arthritis may need to be targeted as aggressively as in diabetes.
Stamatelopoulos
Kimon S
KS
Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, 80, Vassilissis Sofias Ave, Athens, Greece. stamatelopoulosk@yahoo.gr
Kitas
George D
GD
Papamichael
Christos M
CM
Chryssohoou
Elda
E
Kyrkou
Katerina
K
Georgiopoulos
George
G
Protogerou
Athanassios
A
Panoulas
Vasileios F
VF
Sandoo
Aamer
A
Tentolouris
Nikolaos
N
Mavrikakis
Myron
M
Sfikakis
Petros P
PP
D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D050197:Atherosclerosis / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D015995:Prevalence; D012307:Risk Factors
D002097:C-Reactive Protein