title: Lack of association between carotid intima-media wall thickness and carotid plaques and markers of endothelial cell activation in rheumatoid arthritis patients undergoing anti-TNF therapy.
abstract: BACKGROUND
  To determine the relationship between biomarkers of endothelial cell activation, and carotid artery intima-media wall thickness (IMT) and plaques, two surrogate markers of atherosclerosis, in a series of rheumatoid arthritis (RA) patients undergoing anti-TNF therapy.
  
  
  METHODS
  29 consecutive Spanish patients who fulfilled the 1987 American College of Rheumatology classification criteria for RA, had no history of cardiovascular (CV) disease, and had at least one year of follow-up after disease diagnosis were selected. All patients were undergoing anti-TNF-infliximab therapy because of severe disease refractory to conventional disease modifying antirheumatic drugs. Carotid ultrasonography was performed to determine IMT and carotid plaques. Levels of sICAM-3, sICAM-1, sVCAM-1, sPselectin and sE-selectin were assessed by ELISA immediately before an infusion of infliximab.
  
  
  RESULTS
  The median disease duration was 14 years. Despite infliximab, no patient experienced a disease remission (DAS28: median 4.17). Only a marginally significant correlation between sVCAM-1 and carotid IMT was observed when both total correlation using Spearman correlation coefficient (p= 0.08) or partial correlation adjusting for sex, age at the time of study, disease duration, rheumatoid factor, and classic CV risk factors was performed (p= 0.09). Also, no association between presence of carotid plaques and levels of biomarkers of endothelial cell activation was observed.
  
  
  CONCLUSIONS
  In long-standing RA patients without CV disease undergoing anti-TNF therapy no association between levels of soluble markers of endothelial cell activation and carotid ultrasonography abnormalities was observed. Further studies are needed to establish the best tools to be used in the assessment of CV risk of RA.
authors.affiliation: Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain. miguelaggay@hotmail.com
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.forename: José A
authors.initials: JA
authors.lastname: Miranda-Filloy
authors.forename: María T
authors.initials: MT
authors.lastname: García-Unzueta
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000097:blood* / Q000150:complications / Q000473:pathology*; D042783:Endothelial Cells / Q000502:physiology; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab