Carotid intima media thickness as a marker of subclinical atherosclerosis in rheumatoid arthritis: a case control study

Saigal, Renu; Mathur, Vivek; Goyal, Laxmikant

doi:10.18203/2349-3933.ijam20163728

Cited by 7 publications

(5 citation statements)

References 24 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These result in agreement of Jayakumar et al [26] that included 40 RA patients and were compared with 20 age and sex matched control subjects, they found that common carotid artery IMT in RA patients was significantly higher (0.65±0.06) when compared to healthy controls (0.57±0.049). Abd El-Mοnem et al [27], Saigal et al [28], Wang et al [29] and Amin et al [30] were also in agreement with our study.…”

Section: Discussionsupporting

confidence: 92%

Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

El-Sehly

Shahba

Elsheik

et al. 2021

JAMMR

View full text Add to dashboard Cite

Introduction: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in RA disease. In active RA patients, the majority of cardiovascular deaths result from accelerates atherosclerosis. Aim of the Work: The aim of this work is to assess carotid intima media thickness (C-IMT) and endothelial function by brachial artery flow mediated dilatation (FMD) in Rheumatoid arthritis patients and relation to the disease activity. Subjects and Methods: Our study included 50 RA patients, from Tanta University Hospital. 47 women and 3 men and their age ranged from 30-62 years. They were divided into group 1: 25 active RA patients, group 2: 25 inactive RA patients who were diagnosed by American College of Rheumatology (ACR) revised criteria for diagnosis of RA 1987 and disease activity was evaluated using disease activity score 28(DAS28). Group 3: 25 normal subjects as a control group. We measured C-IMT and FMD in all groups. Results: By comparing the groups, we found that active RA patients had increased C-IMT compared to inactive rheumatoid arthritis patients and controls which is indicator of atherosclerosis. FMD of the brachial artery impaired in RA patients compared to controls which is indicator of endothelial dysfunction. There was highly statistically significant relation between duration, activity of RA disease and atherosclerosis in RA patients. Conclusion: With increasing the frequency of atherosclerosis in asymptomatic RA patients, carotid IMT increased and FMD impaired when compared with general population. Active RA patients have increased carotid IMT and impaired FMD compared with inactive RA patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

El-Sehly

Shahba

Elsheik

et al. 2021

JAMMR

View full text Add to dashboard Cite

show abstract

“…This clearly suggests that CIMT increases in patients with Rheumatoid arthritis compared to normal population. Saigal R et al (1) also found significantly higher CIMT in RA patients (0.68_+ 0.06mm). Singh et al also reported higher CIMT in RA patients compared to controls, (12) Patel S, Bhatt K, Patel A et al found mean CIMT in RA group to be 0.86_+0.18 mm and that of control group as 0.53+_0.15 mm .…”

Section: Discussionmentioning

confidence: 83%

“…So, Control had the larger proportion of ESR: ≤20 mm/hour and Cases had the larger proportion of ESR: >20 mm/Hr. Saigal R et al (1) and Mandal et al (13) also found significantly higher ESR in RA patients (51.75+_24.13 mm/hour) in comparison to control group.…”

Section: Discussionmentioning

confidence: 88%

“…Rheumatoid arthritis (RA) is a chronic systemic inflammatory, auto-immune disease of unknown origin with characteristic persistent symmetric polyarthritis (synovitis) and extra articular involvement of skin, heart, lungs and eye. (1) Although a disease of joints, abnormal immunological responses can lead to a variety of extra-articular manifestations including the involvement of blood vessels and heart. (2) The risk of death is two-fold higher in RA patients than in general population and the main cause of mortality is cardiovascular disease (CVD), accounting for about a half of premature deaths observed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A study of carotid intima media thickness in patients with rheumatoid arthritis and its correlation with acute phase reactants and disease activity

Sachin Kumar,

Abhijeet Kumar,

Jyoti Prabha

2024

Int. J. Sci. Res. Arch.

View full text Add to dashboard Cite

Introduction: There is increased risk of cardiovascular morbidity and mortality in patients of rheumatoid arthritis (RA) due to accelerated atherosclerosis. In this study we measured Carotid artery intima media thickness (CIMT) as a surrogate marker for subclinical atherosclerosis in RA patients without pre-existing cardiovascular disease. This study also analyzed the correlation between CIMT, disease duration, Simplified Disease Activity Index (SDAI) and acute phase reactants. Methods: A cross-sectional study was conducted on 90 patients divided into two groups of 45 patients of RA and another 45 control subjects. Subjects with RA and age and sex matched healthy controls were included in the study without pre-existing CV risk factors. Complete clinical evaluation, hematological and biochemical profile done. ESR, CRP and platelet count were used as markers of acute phase reactants. All the RA patients included in the study were evaluated for their disease activity using Simplified Disease Activity Index (SDAI). All the subjects including the controls evaluated for carotid intima media thickness by using carotid ultrasonography. CIMT measured in common carotid artery bilaterally by examining throughout common carotid artery up to 2 cm proximal to bifurcation. CIMT measurement taken at the site of greatest thickness. All measurements taken in diastole, measured in phase when lumen diameter is at its smallest and IMT at its largest. Mean value of 6 readings (3 from each side) taken as final CIMT for evaluation. B mode (linear probe) USG was used to determine carotid IMT. Results: 45 cases and similar control subjects included in the study with mean age (SD) as 45.07 (14.81) years. We found female preponderance with 37 females out of 45 cases. Mean (SD) disease duration in male subjects was 5.38(2.40) years while in females was 5.09 (2.78) years. CRP was found to be significantly increased in cases group with mean (SD) of 5.75(8.85) mg/dl. ESR significantly raised to 35.22(13.55) mm/hour in cases group compared to control group where it was 16.16(5.71) mm/hr. Mean (SD) platelets (x10³/mm³) were 229.24(69.80) in cases while controls had 290.33(83.85), so platelets correlation with disease could not be established. CIMT was significantly raised in cases group. Mean (SD) CIMT in cases was 0.95(1.06) mm whereas in control group it was 0.60(0.16) mm with p value of 0.002. Moderate positive correlation was found between CIMT (mm) and SDAI and this correlation was statistically significant with p=0.001. For every 1 unit increase in CIMT, the SDAI increases by 2.92 units. A strong positive correlation between CIMT (mm) and Disease Duration (Years), and this correlation was statistically significant (rho = 0.9, p = <0.001). For every 1 unit increase in CIMT (mm), the Disease Duration (Years) increases by 1.26 units. Conversely, for every 1 unit increase in Disease Duration (Years), the CIMT (mm) increases by 0.19 units. Conclusion: A strong correlation was observed between CIMT and disease duration in rheumatoid arthritis. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA. In view of the relation to duration of disease, established RA patients should regularly be screened to identify the evidence of atherosclerosis and manage it earlier. Prevention of cardiovascular disease in RA requires an integrated approach encompassing cardiovascular risk factors screening and management, effective and sustained control of RA disease activity, high index of suspicion and prompt investigation of suspected cardiac disease.

show abstract

“…Mohan et al also showed that RA patients have higher values of cIMT compared to healthy population stressing out the point that this finding "appears to be a useful surrogate marker for detecting subclinical atherosclerosis in adults" 33 . Saigel and coauthors went even further by suggesting routine screening for a silent atherosclerosis in all RA patients by ultrasound examination of cIMT 34 . Ristic et al showed that RA represents an independent risk factor for atherosclerosis and, what is even more important, that long-term anti-inflammatory therapy may decrease cIMT 29 .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of atherosclerotic plaque and the thickness of the carotid artery intima-media complex in patients with rheumatoid arthritis

et al. 2023

View full text Add to dashboard Cite

Background/Aim. Rheumatoid arthritis (RA) represents an independent risk factor for the development of cardiovascular diseases. Early detection of atherosclerotic changes is of tremendous importance in prevention of cardiovascular events. An increase in the carotid artery intima-media thickness (cIMT) is considered to be a sensitive marker of early subclinical atherosclerosis. The aim of our paper was to assess the cIMT, the number and type of carotid plaques (CP) and the severity of carotid artery stenosis in RA patients. Furthermore, we investigated the correlation between the all above mentioned parameters and disease duration and activity. Methods. The research was conducted on 92 participants - 58 RA patients and 34 control group participants. In patients with RA clinical examination and laboratory findings were used for assessing disease activity. All participants underwent color Doppler ultrasonography of carotid arteries with a linear probe. Results. The mean cIMT in RA patients was statistically significantly higher compared to the control group (0.82?0.23 mm vs 0.66?0.18 mm; p<0.01). CP were found in 34/58 RA patients (58.62%) and 4/34 (11.76%) in the control group (p<0.001). The number of CP per a patient was significantly higher in RA group compared to the control group (1.42?0.98 vs 0.18?0.38; p<0.001). The cIMT, presence and number of CP and the severity of carotid artery stenosis were not statistically significantly related to disease activity. There was a statistically significant direct correlation between duration of RA and the percentage of carotid arterial stenosis (?=0.320, p=0.034). Conclusion. The cIMT, presence and number of plaques per a patient and severity of carotid artery stenosis were significantly higher in RA patients. Also, there was a positive correlation between disease duration and severity of carotid artery stenosis. Our study showed that RA represents an independent risk factor for an increase in cIMT and the development of subclinical atherosclerosis.

show abstract

Carotid intima media thickness as a marker of subclinical atherosclerosis in rheumatoid arthritis: a case control study

Cited by 7 publications

References 24 publications

Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

A study of carotid intima media thickness in patients with rheumatoid arthritis and its correlation with acute phase reactants and disease activity

Characteristics of atherosclerotic plaque and the thickness of the carotid artery intima-media complex in patients with rheumatoid arthritis

Contact Info

Product

Resources

About