title: Early phase clinical and biological markers associated with subclinical atherosclerosis measured at 7 years of evolution in an early inflammatory arthritis cohort.
abstract: OBJECTIVE
  Accelerated atherosclerosis has emerged as a critical issue in rheumatoid arthritis (RA). There is a need to better understand the link between RA and atherosclerosis. Our aim was to identify parameters associated with the development of subclinical atheroma in a very early arthritis (VErA) cohort.
  
  
  METHODS
  VErA-cohort patients were prospectively recruited from 1998 to 2002. Arthritis treatment was standardised from onset. The clinical, biological and radiological parameters of all patients were collected from inclusion. Carotid intima-media thickness (cIMT) was measured 7 years after their first symptoms.
  
  
  RESULTS
  Among 105 patients included, 82 developed RA (mean age at onset: 51.7±12.8 years). Mean carotid artery IMT at year 7 was 0.67±0.12 mm. Larger thickness defined by values above the median (0.66) was associated with inclusion age (p<10-6), swollen joint count (p=0.01), DAS44 (p=0.048) and hypertension (p=0.006). In contrast, anti-CCP positivity (>50 UA/ml) was associated with thinner cIMT (p=0.03). Baseline as well as cumulated values of markers reflecting systemic inflammation, lymphocyte activation, endothelial dysfunction and oxidative stress were not correlated with carotid subclinical atherosclerosis. Major independent atheroma risk factors retained by multivariate analyses were hypertension (OR 4.33 [1.59-11.73]; p=0.004) and swollen joint count at inclusion (OR 3.87 [1.54-9.72]; p=0.004), while methotrexate use was a protective marker (OR 0.27 [0.11-0.71]; p=0.007).
  
  
  CONCLUSIONS
  This study conducted from the VErA vascular cohort of community-cases of RA confirm that cIMT is under the influence of classical CV risk (hypertension), disease marker (SJC) and methotrexate intake.
authors.affiliation: Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: Vandhuick
authors.affiliation: Paris Descartes University, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.affiliation: Paris Descartes University, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Borderie
authors.affiliation: Radiology Department, Rouen University Hospital, Rouen, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Louvel
authors.affiliation: Rheumatology Department, Amiens University Hospital, Amiens, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Fardellone
authors.affiliation: Paris Diderot University, Bichat Claude-Bernard Hospital, Assistance Publique des Hôpitaux de Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
authors.affiliation: Rheumatology Department, Amiens University Hospital, Amiens, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Goëb
authors.affiliation: INSERM UMR 1125 and Rheumatology Department, CHU Avicenne (APHP), Bobigny; and Department of Internal Medicine, Fondation A. De Rothschild, Paris, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Clavel
authors.affiliation: INSERM UMR 1125 and Rheumatology Department, CHU Avicenne (APHP), Bobigny, France.
authors.forename: Marie Christophe
authors.initials: MC
authors.lastname: Boissier
authors.affiliation: Inserm Unit 905, IRIB, Rouen University, Rouen, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Jouen
authors.affiliation: Rheumatology Department, Amiens University Hospital, Amiens, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Boumier
authors.affiliation: Radiology Department, Pauchet Hospital, Amiens, France.
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Allart
authors.affiliation: Rheumatology Department, Rouen University Hospital, Rouen, France.
authors.forename: Othmane
authors.initials: O
authors.lastname: Mejjad
authors.affiliation: Rheumatology Department, Rouen University Hospital, Rouen, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.affiliation: Biostatistics Department, Rouen University Hospital, Rouen, France.
authors.forename: Mary
authors.initials: M
authors.lastname: Jan
authors.affiliation: Biostatistics Department, Rouen University Hospital, Rouen, France.
authors.forename: Jean François
authors.initials: JF
authors.lastname: Ménard
authors.affiliation: Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.affiliation: Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France. olivier.vittecoq@chu-rouen.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D059168:Carotid Intima-Media Thickness; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood*; D007596:Joints / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D008727:Methotrexate