Atherosclerotic disease is increased in recent onset rheumatoid arthritis: a
critical role for inflammation

Suad Hannawi , Brian Haluska , Thomas H Marwick  and Ranjeny Thomas

Arthritis Research & Therapy 2007, 9:R116doi:10.1186/ar2323

Published: 6 November 2007

Abstract (provisional)
RA patients have increased mortality and morbidity as a result of
cardiovascular and cerebro-vascular disease. However, it is neither clear
how early accelerated atherosclerosis begins in RA, nor how soon risk
factors must be rigorously controlled. Furthermore, given the strong
relationship of vascular disease to RA mortality and of inflammation to the
accelerated atherosclerosis associated with RA, it is important to evaluate
indices which could serially and non-invasively quantify atherosclerotic
disease in RA patients. Carotid intima-media thickness (cIMT) and plaque,
measured by ultrasound, correlate closely with direct measurement of local
and systemic atherosclerotic burden. To investigate the presence of
sub-clinical atherosclerosis in the early stages of RA, cIMT and plaque were
measured using carotid duplex scanning in 40 RA patients with disease
duration of less than 12 months and 40 control subjects matched for age, sex
and established cardiovascular risk factors. Patients with RA had
significantly higher average cIMT values and more plaque than the control
group (cIMT 0.64 +/- 0.13 mm vs. 0.58 +/- 0.09 mm respectively, p = 0.03).
In RA patients, cIMT was predicted by age and C-reactive protein (CRP) level
at first presentation to the clinic (R2 = 0.64). CRP was associated with age
of disease onset and history of smoking. Since inflammation has been shown
to predate onset of clinical RA, the accelerated atherogenic process related
to inflammation may precede RA symptom onset.

Full text available at
http://arthritis-research.com/content/9/6/R116
--
Jim Chinnis   Warrenton, Virginia, USA