ABSTRACT
Cardiovascular disease is an increasingly recognized contributor to excess morbidity and mortality in rheumatoid arthritis [RA]. Traditional cardiovascular risk factors do not adequately account for the extent of cardiovascular disease in RA. To study the relative impact of traditional versus non-traditional cardiovascular risk factors on endothelial dysfunction, as an early essential step for atherosclerosis, in patients with RA. Twenty five consecutive outpatients with RA were collected and compared to 15 healthy, age and sex matched controls.Both groups undergone assessment of traditional cardiovascular risk factors [high blood pressure, diabetes and smoking] as well as other non- traditional cardiovascular risk factors [hs CRP, ESR, serum ICAM] along with bilateral measurement of intima media thickness IMT of common carotid artery [IMT-CCA]. There was highly significant difference in T-chol /HDL [cardiac risk ratio] between the two groups [RA patients and controls]. Also there was a highly significant difference between the two groups as regards inflammatory markers [non-traditional risk factors], IMT and s-ICAM. RA patients with increased IMT-CCA had higher T-chol/ HDL [cardiac risk ratio] [P < 0.05], as well as high DAS and ESR [P < 0.01] compared to RA patients with normal IMT-CCA. Patients with positive RF had increased IMT-CCA [P < 0.05] and higher serum levels ICAM-1[P < 0.01] than those with negative RF. We also found that IMT-CCA was significantly positively correlated to markers of disease activity, while serum levels ICAM-1 was significantly positively correlated to disease duration. Patients with rheumatoid arthritis have a high prevalence of preclinical atherosclerosis independent of traditional risk factors, suggesting that chronic inflammation and disease severity are atherogenic to this population. That is why proper and strict control of disease activity may play a preventive role in this setting