title: Cardiovascular risk assessment in patients with rheumatoid arthritis: a correlative study of noninvasive arterial health testing.
abstract: This study aimed to determine the relationship between noninvasive measures of arterial health and both estimated 10-year cardiovascular risk and measures of disease activity over time in established rheumatoid arthritis. Fifty rheumatoid arthritis patients underwent noninvasive arterial health testing (brachial artery reactivity, aortic augmentation index [AIx], pulse wave velocity, carotid artery intima-media thickness, and carotid artery plaque presence) and assessment of clinical disease activity (tender or swollen joint counts, Clinical Disease Activity Index [CDAI], and Health Assessment Questionnaire II [HAQ-II]). Clinical measures during 3 years before the study visit were averaged. Arterial health testing was compared with the American Heart Association/American College of Cardiology (AHA/ACC) Pooled Cohort Equation. Spearman methods identified correlations between disease activity measures, cardiac biomarkers, and arterial health parameters. Among the patients (mean age, 57.5 years), disease activity was moderate (mean [SD] CDAI, 16.9 [15.3]). At the study visit, corrected aortic augmentation index correlated with CDAI (r = 0.37, P = .009) and HAQ-II (r = 0.33, P = .02). AIx correlated with time-averaged tender joint count (r = 0.37, P = .008), CDAI (r = 0.36, P = .01), HAQ-II (r = 0.36, P = .01), swollen joint count (r = 0.36, P = .10), patient global assessment (r = 0.33, P = .02), physician global assessment (r = 0.35, P = .01), and pain score (r = 0.38, P = .007). The AHA/ACC low-risk group (<5% 10-year risk) had highest prevalence of carotid plaques. Arterial health testing may identify increased risk of cardiovascular disease compared with risk obtained through AHA/ACC Pooled Cohort Equation. Measures of arterial stiffness correlate with the burden of disease activity over time.
authors.affiliation: Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. scanlon.erin@mayo.edu.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Scanlon
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rekha
authors.initials: R
authors.lastname: Mankad
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Iftikhar J
authors.initials: IJ
authors.lastname: Kullo
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Mulvagh
authors.affiliation: Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.|Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Kvrgic
authors.affiliation: Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Davis
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D015415:Biomarkers; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D059168:Carotid Intima-Media Thickness; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers
keywords: Brachial artery reactivity testing; Carotid artery intima-media thickness; Endothelial dysfunction; Flow-mediated dilation; Rheumatic disease; Swollen joint count; Tender joint count