title: The Additive Value of Femoral Ultrasound for Subclinical Atherosclerosis Assessment in a Single Center Cohort of 962 Adults, Including High Risk Patients with Rheumatoid Arthritis, Human Immunodeficiency Virus Infection and Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Presence of femoral atheromatic plaques, an emerging cardiovascular disease (CVD) biomarker additional to carotid plaques, is poorly investigated in conditions associating with accelerated atherosclerosis such as Rheumatoid Arthritis (RA), Human Immunodeficiency Virus (HIV) infection and Type 2 Diabetes Mellitus (T2DM).
  
  
  OBJECTIVE
  To assess the frequency of femoral/carotid subclinical atheromatosis phenotypes in RA, HIV and T2DM and search for each disease-specific probability of either femoral and/or carotid subclinical atheromatosis, we examined by ultrasound a single-center cohort of CVD-free individuals comprised of consecutive non-diabetic patients with RA (n=226) and HIV (n=133), T2DM patients (n=109) and non-diabetic individuals with suspected/known hypertension (n=494) who served as reference group.
  
  
  RESULTS
  Subclinical atheromatosis--defined as local plaque presence in at least on arterial bed--was diagnosed in 50% of the overall population. Among them, femoral plaques only were found in 25% of either RA or HIV patients, as well as in 16% of T2DM patients and 35% of reference subjects. After adjusting for all classical CVD risk factors, RA and HIV patients had comparable probability to reference group of having femoral plaques, but higher probability (1.75; 1.17-2.63 (odds ratio; 95% confidence intervals), 2.04; 1.14-3.64, respectively) of having carotid plaques, whereas T2DM patients had higher probability to have femoral and carotid plaques, albeit, due to their pronounced dyslipidemic profile.
  
  
  CONCLUSIONS
  RA and HIV accelerate predominantly carotid than femoral. A "two windows" carotid/femoral, rather than carotid alone ultrasound, screening improves substantially subclinical atheromatosis detection in patients at high CVD risk.
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece; Joint Academic Rheumatology Program of the National and Kapodistrian University of Athens Medical School, Athens, Greece.
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Protogerou
authors.affiliation: Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Fransen
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece; Joint Academic Rheumatology Program of the National and Kapodistrian University of Athens Medical School, Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Zampeli
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: Antonis A
authors.initials: AA
authors.lastname: Argyris
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: Evagelia
authors.initials: E
authors.lastname: Aissopou
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece; Joint Academic Rheumatology Program of the National and Kapodistrian University of Athens Medical School, Athens, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Arida
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece; Joint Academic Rheumatology Program of the National and Kapodistrian University of Athens Medical School, Athens, Greece.
authors.forename: George D
authors.initials: GD
authors.lastname: Konstantonis
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Tentolouris
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Makrilakis
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: Mina
authors.initials: M
authors.lastname: Psichogiou
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Daikos
authors.affiliation: Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, United Kingdom; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, United Kingdom.
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
authors.affiliation: First Department of Propaedeutic & Internal Medicine, Laikon Hospital, Athens, Greece; Joint Academic Rheumatology Program of the National and Kapodistrian University of Athens Medical School, Athens, Greece.
authors.forename: Petros P
authors.initials: PP
authors.lastname: Sfikakis
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000000981:diagnostic imaging; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000032:analysis; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D058226:Plaque, Atherosclerotic / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012307:Risk Factors; D012720:Severity of Illness Index; D013848:Thigh / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D015415:Biomarkers