title: Traditional cardiovascular risk factors or inflammation: Which factors accelerate atherosclerosis in arthritis patients?
abstract: Patients with chronic inflammatory arthritis experience an increased incidence of cardiovascular (CV) events. In addition to visualizing atherosclerotic plaques, ultrasound examinations (USs) of the carotid arteries permit the measurement of subclinical markers of atherosclerosis, such as intima-media thickness (cIMT) and carotid segmental distensibility (cDC). The aims of the study were to identify the determinants of atherosclerosis acceleration (plaques, cIMT and cDC) in a sample of patients suffering from chronic arthritis and to compare these patients with a control group of people with ≤1 traditional risk factor (TRF) for CV disease.
  
  
  METHODS
  We recruited 137 patients with rheumatoid arthritis (RA), 43 patients with psoriatic arthritis (PsA), 28 patients with ankylosing spondylitis (AS) and 48 healthy volunteers without histories of previous CV events. These patients underwent carotid artery US examinations using dedicated hardware.
  
  
  RESULTS
  Regression and multivariate analyses demonstrated that only age (p<0.001) was consistently associated with cDC, cIMT and atherosclerotic plaques, both in the entire sample of patients with arthritis and in the subgroup of patients with RA. Among modifiable TRFs for cardiovascular disease, only hypertension, diabetes mellitus and smoking exhibited associations with some carotid phenotypes, with borderline significance. When patients with RA carrying ≤1 TRF were compared with control subjects carrying ≤1 TRF, only cDC was slightly lower in the RA group than in the control group.
  
  
  CONCLUSIONS
  Age is the major determinant of subclinical atherosclerosis in patients with different types of arthritis, as the contributions of other TRFs and disease activity and duration indices to the disease seem to be limited.
authors.affiliation: Division of General Medicine and Hypertension, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. Electronic address: andrea.dalbeni@ospedaleuniverona.it.
authors.forename: A
authors.initials: A
authors.lastname: Dalbeni
authors.affiliation: Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giollo
authors.affiliation: Division of General Medicine and Hypertension, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tagetti
authors.affiliation: Division of General Medicine and Hypertension, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Atanasio
authors.affiliation: Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Orsolini
authors.affiliation: Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cioffi
authors.affiliation: Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ognibeni
authors.affiliation: Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rossini
authors.affiliation: Division of General Medicine and Hypertension, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Minuz
authors.affiliation: Division of General Medicine and Hypertension, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Fava
authors.affiliation: Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Viapiana
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: Ankylosing spondylitis; Atherosclerotic plaques; Carotid distensibility; Intima-media thickness; Psoriatic arthritis; Rheumatoid arthritis; Traditional risk factors