Carotid artery intima-media thickness and brachial artery flow-mediated vasodilatation in patients with rheumatoid arthritis.
BACKGROUND
Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Our study aim was to determine the relationship between carotid artery intima-media wall thickness (IMT) and flow-mediated endothelium-dependent vasodilatation (FMD) in a patients with RA, in context with clinical and laboratory measurements.


METHODS
Fifty-two patients with RA and 30 matched healthy controls without clinically evident CV disease were studied. Brachial and carotid ultrasonography was performed to determine FMD and IMT, respectively. We also assayed immunological, inflammatory and metabolic laboratory markers.


RESULTS
IMT was significantly higher in RA patients (1.00 ± 0.16 mm) patients than in controls (0.89 ± 0.13 mm) (P = 0.001). FMD was significantly lower in RA (9.16 ± 7.03) as compared to controls (12.60 ± 5.49) (p = 0.005). RA patients had significant positive correlations between erythrocyte sedimentation rate (ESR) (r=0.395 p = 0.021) and IMT and negative correlation between visual analog scale (VAS) (r= -0.311, p= 0.025) and IMT. RA patients who used low doses of corticosteroids have, statistically, significantly better FMD, than those who do not use corticosteroids. Linear regression analysis revealed that IMT was related to tender joint count (p = 0.008), VAS (p < 0.001), ESR (p = 0.048) and total cholesterol/high density lipoprotein cholesterol ratio (p = 0.039).


CONCLUSIONS
In patients with RA, FMD was impaired and IMT was increased, indicating early endothelial dysfunction and accelerated atherosclerosis. Early treatment of disease may reduce the risk of atherosclerosis in RA.
Department of Rheumatology, Clinical Center Kragujevac, Serbia.
Mirjana V
MV
Veselinovic
Vladimir I
VI
Zivkovic
Slavco
S
Toncev
Nebojsa
N
Tasic
Vesna
V
Bogdanovic
Dragan M
DM
Djuric
Vladimir Lj
VLj
Jakovljevic
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology*