AB1291 Carotid intima-media thickness is increased in mexican-mestizo patients with rheumatoid arthritis: a case-control study

Abstract

BackgroundPatients with rheumatoid arthritis (RA) have a significantly increased risk for cardiovascular (CV) morbidity and mortality when compared to general population. Traditional risk factors do not explain the increased CV risk, which appears to be linked to chronic inflammation.1 The leading cause of death in RA-patients is atherosclerotic cardiovascular disease (ASCVD).2 Carotid artery evaluation by ultrasound is a useful tool for the detection of subclinical atherosclerosis. The presence of increased carotid intima-media thickness (CIMT) significantly raises the risk of ASCVD, mainly stroke and myocardial infarction.3 ObjectivesTo compare CIMT between Mexican-mestizo RA-patients and matched controls.MethodsDesign: observational, cross-sectional, case-control study. Patients 40 to 75 years old who fulfilled the 2010 ACR/EULAR and/or the 1987 ACR classification criteria for RA were consecutively enrolled. Patients with previous ASCVD or any other rheumatic disease were excluded. Carotid artery wall hypertrophy (CAWH) was defined as a CIMT≥0.9 and<1.2 mm whereas carotid plaque (CP) was defined as a CIMT≥1.2 mm or a≥50% focal increase of CIMT compared to the surrounding wall.ResultsA total of 100 RA-patients and 49 matched control subjects were included in the final analysis. Their characteristics are shown in Figure 1. RA-patients had a median disease duration of 10.3 years and a median DAS-28–CRP of 3.2. Regarding carotid ultrasound findings, there was a significant difference in CAWH and average CIMT between groups (p<0.001).Abstract AB1291 – Figure 1Demographic CharacteristicsSD: Standard deviation, DM2: Type 2 diabetes mellitus, CAWH: Carotid artery wall hypertrophy, CIMT: Carotid intima-media thickness.ConclusionsThere was significantly increased CIMT and presence of CAWH in RA-patients compared to matched controls. These findings might be major contributors to the increased CV morbidity and mortality of RA-patients. Further research is needed to determine the relationship between RA-specific factors such as disease duration and activity and the presence and magnitude of carotid ultrasound abnormalities.References[1] Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Cardenas-de la Garza JA, Vera-Pineda R, Garcia-Colunga JI, et al. Comparison of statin eligibility according to the Adult Treatment Panel III, ACC/AHA blood cholesterol guideline, and presence of carotid plaque by ultrasound in Mexican mestizo patients with rheumatoid arthritis. Clin Rheumatol. 2016;35(11):2823–7.[2] Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Annals of the rheumatic diseases. 2012;71(9):1524–9.[3] Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of the rheumatic diseases. 2017;...