Subclinical atherosclerosis in patients with early rheumatoid arthritis

ABSTRACT

Rheumatoid arthritis [RA] patients have increased mortality and morbidity as a result of cardiovascular [CV] and cerebrovascular diseases. Surprisingly the extent of atherosclerosis [AS] in RA is not known, nor have standard CVD risk factors have been fully evaluated. Study of these changes in early RA and early diagnosis of AS in this population might trigger more aggressive prophylaxis. To demonstrate subclinical atherosclerosis in early RA and possible underlying mechanism. 60 patients with early RA and 40 controls matched for age, sex and traditional risk factors for AS were selected. All patients and controls were subjected to a complete history and full clinical examination, laboratory assessment and carotid ultrasonography. Patients with early RA had average greater cIMT than controls and an increased prevalence of atherosclerotic plaques. Positive association between cIMT and age, joint count, disease activity score [DAS], smoking, serum cholesterol and c-reactive protein [CRP] were observed. Age and CRP were independently associated with atherosclerosis. Patients with early RA developed accelerated atherosclerosis compared with controls. Age and CRP are strong predictors for occurrence of CV disease before onset of symptoms