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Background A growing body of evidence supports that patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular diseases (CVDs). Early detection of vascular lesions in the preclinical phase would be of great benefit for CVD prevention and its prognosis. Several non-invasive methods have been developed and used for early detection of vascular changes in patients with RA. Objectives The aim of this study was to investigate the carotid arterial stiffness in RA patients without cardiovascular risk factors using echo-tracking ultrasonography and its association with clinical parameters of RA. Methods This study included 51 female RA patients and 44 female healthy controls without any known traditional CV risk factors. Arterial stiffness index β (β index) is assessed by echo-tracking ultrasonography in the common carotid artery (CCA) and the carotid intima-media thickness (cIMT) were also measured. RA activity was assessed by high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) and disease activity score in 28 joints (DAS28). 25-hydroxyvitamin D (25(OH)D) and autoantibodies such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP) were checked. Results Compared with the control group, the RA group were significantly higher β index (9.371±2.927 vs 7.397±3.140, p=0.02). However, we did not find any differences in IMT between two groups. In the RA group, β index was significantly correlated with age (r =0.435, p=0.001), disease duration (r=0.373, p=0.007) and RF (r=0.412, p=0.003). Older age and longer disease duration were associated with increased β index in univariable regression analyses (Table 1). Multivariable regression analysis also revealed that the significant predictors of β index were age and disease duration after adjustment for confounding factors (Table 1). Conclusions RA is associated with preclinical vascular changes, characterized by increased carotid β index values, which have been shown to be related to age and disease duration rather than autoantibodies or disease activity. References Villa-Forte A, Mandell BF. Cardiovascular disease and rheumatic disease. Rev Esp Cardiol 2011;64(9):809-817. Mackenzie IS, Wilkinson IB, Cockcroft JR. Assessment of arterial stiffness in clinical practice. QJM 2002;95(2):67-74. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2897

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Background Although there is increasing evidence that low serum 25-hydroxy vitamin D (25-OHD) is associated with a higher frequency of cardiovascular diseases (CVDs) in the general population, little attention has been given to the relationship between vitamin D deficiency and atherosclerosis in patients with rheumatoid arthritis (RA). Objectives The present study aimed to investigate whether vitamin D deficiency is a potential risk factor for carotid atherosclerosis in patients with (RA). Methods With a cross-sectional design, we recruited 60 consecutive female RA patients without previous CVDs between September 2013 and December 2013 at the outpatient rheumatology clinic of a tertiary referral centre in South Korea. Carotid intima media thickness (CIMT) was measured using high-resolution ultrasonography (Philips HD15, Bothwell, WA, USA) and QLAB's IMT-quantification software plug-in (Philips Healthcare, DA Best, The Netherlands) was used to enhance the consistency and reliability of CIMT measurement. Serum 25-OHD levels were assessed by radioimmunoassay. Stepwise multivariable linear regression models were used to evaluate the association between serum 25-OHD levels and CIMT. Results Mean (SD) age and disease duration were 56.0 (11.2) and 5.9 (4.9) years, respectively. Median 25-OHD levels (IQR) was 14.0 (11.0-20.7) ng/mL and 74% of patients had vitamin D deficiency (<20ng/mL). Mean (SD) CIMT was 0.58 (0.08) mm and 24 (48%) RA patients had abnormal CIMT (≥6 mm). Compared to RA patients with normal CIMT (<6mm), those with abnormal CIMT (≥6 mm) were older and had longer disease duration, lower serum 25-OHD levels and high density lipoprotein (HDL) and higher disease activity score (DAS) 28 and Korean version of health assessment questionnaire (K-HAQ) score. In univariable analyses, lower serum 25-OHD levels and HDL, older age, and higher DAS28 and K-HAQ scores were associated with increased CIMT (Table 1), while disease duration, blood pressure, triglyceride, low density lipoprotein and Homeostatic model assessment - insulin resistance showed no association with CIMT. Serum 25-OHD levels remains statistically significant in multivariable regression models after adjusting confounding factors (Table 1). Table 1. Linear regression models evaluating the association between serum vitamin D levels and carotid intima media thickness Univariable analysis Model 1* Model 2** β (SE) P β (SE) P β (SE) P Serum 25-OHD, ng/mL −0.001 (4.8–4) 0.044 −0.001 (3.7–4) 0.010 −0.001 (3.7–4) 0.043 Age, years 0.003 (7.2–4) <0.001 0.003 (7.2–4) <0.001 0.003 (7.1–4) <0.001 BMI, kg/m2 0.005 (0.003) 0.106 0.007 (0.002) 0.008 0.006 (0.002) 0.011 HDL, mg/dL −0.001 (5.2–4) 0.054 DAS28-ESR 0.021 (0.010) 0.034 0.015 (0.008) 0.076 K-HAQ 0.0511 (0.015) 0.002 0.041 (0.064) 0.011 Adjusted R2 0.448 0.489 25-OHD, 25-hydroxy vitamin D; BMI, body mass index; HDL, high density lipoprotein; DAS28-ESR, disease activity score 28 – erythrocyte sedimentation rate; K-HAQ, Korean version of health assessment questionna...

BackgroundThe incidence of hearing loss (HL) has been on the rise in patients with rheumatoid arthritis (RA). However, limited information exists regarding the pathogenic mechanisms of HL in RA patients1,2.ObjectivesThis study sought to evaluate the prevalence and characteristics of HL in RA patients compared with a control group and to identify factors associated with the degree of HL in RA patients.MethodsWe enrolled 64 RA patients and 70 healthy controls in a prospective manner. Each subject was tested with pure tone audiometry including high frequencies ranging from 0.5 to 16 kHz. For each set of tests, mean values for air conduction at each frequency and tympanometric values were calculated to exclude middle ear disease. In the RA group, auto-antibodies, erythrocyte sedimentation rate, high-sensitivity C-reactive protein, and RA disease activity were measured, and carotid ultrasonography was performed for the detection of indicators of subclinical atherosclerosis, including arterial stiffness index beta (β-index) and carotid intima-media thickness (cIMT).ResultsThe prevalence of HL was higher in the RA group than the control group (37.1% vs. 65.6%, p=0.001). The hearing threshold value difference between groups was significant at frequencies of 0.5, 1, 2, 4, and 8 kHz (p<0.05). Age showed the strongest correlation to HL at all frequencies in RA patients (p<0.01). cIMT was also strongly related to HL at all frequencies, whereas β-index was related to HL only at high frequencies (8, 12, and 16 kHz), acting as an early marker of HL (both p<0.05).ConclusionsHL was more prevalent in the RA group than the control group. cIMT and β-index were strongly correlated with HL in the RA group, which implies that subclinical atherosclerosis may play an important role in HL in RA patients.ReferencesÖzkırış M, Kapusuz Z, Günaydın İ, Kubilay U, Pırtı İ, Saydam L. Does rheumatoid arthritis have an effect on audiovestibular tests? Eur Arch Otorhinolaryngol. 2014;271:1383–7Pascual-Ramos V, Contreras-Yáñez I, Rivera-Hoyos P, Enríquez L, Ramírez-Anguiano J. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA). Clin Rheumatol. 2014;33:315–21.Disclosure of InterestNone declared