Predictors of subclinical atherosclerosis in patients with rheumatoid arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder involving the joints along with various other extra-articular manifestations. Mortality due to coronary artery disease is higher in patients with RA when compared to the general population. Hence, this study is undertaken to assess the predictors of sub-clinical atherosclerosis in patients with RA, so that early prompt management can prevent cardiovascular complications. Methods: A case–control study with 42 patients of RA and 42 healthy age- and sex-matched controls was undertaken. Relevant investigations were done. Disease Activity Score (DAS)-28 was calculated. Carotid artery doppler was performed on both sides to examine the common carotid artery. Results: The mean carotid intima–media thickness (CIMT) (mm) was significantly higher in RA patients compared to controls on the right side (0.57 ± 0.11 Vs 0.40 ± 0.03; P < 0.001) as well as left side (0.56 ± 0.11 Vs 0.39 ± 0.06; P < 0.001). Only age (P = 0.006) and DAS-28 (P = 0.002) showed a positive correlation with CIMT. Conclusions: CIMT can be used as a marker for the detection of subclinical atherosclerosis and the risk of atherosclerosis increases with the increasing age and increasing disease severity.

Keywords

• carotid artery doppler
• carotid intima–media thickness
• disease activity score-28
• rheumatoid arthritis
• subclinical atherosclerosis