Document Detail

Subclinical peripheral arterial disease in rheumatoid arthritis.
MedLine Citation:
PMID:  20553683     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Rheumatoid arthritis (RA) is associated with accelerated atherosclerosis in the carotid arteries, but little is known about the magnitude of this process in peripheral arteries. Assessing preclinical atherosclerosis in both arterial beds in RA might provide additional prognostic value during risk stratification for primary prevention. Therefore in the present structural study we examined femoral versus carotid subclinical atherosclerosis in RA and controls.
METHODS: Intima-media thickness (IMT) and atheromatous plaque presence and vulnerability in femoral versus carotid arteries were examined in 80 RA patients without overt cardiovascular disease or diabetes and 80 controls matched 1:1 for age, gender and traditional cardiovascular disease risk factors.
RESULTS: Femoral IMT and plaque prevalence were increased in RA than controls (p=0.001 and 0.008, respectively). These increases remained significant after adjustment for potentially confounding factors that differed between groups, such as C-reactive protein and HDL-cholesterol serum levels, and statin use. Femoral plaque vulnerability did not differ between RA and controls. The presence of RA was found to be an independent predictor of increased femoral IMT (p=0.004), after adjustment for traditional cardiovascular risk factors, C-reactive protein and treatment with angiotensin converting enzyme inhibitors and statins. Femoral plaques were less frequent than carotid plaques in RA patients (22.5% vs 45.0% respectively, p=0.003) and in contrast to carotid plaques were independent of age and glucose levels.
CONCLUSIONS: Subclinical peripheral atherosclerosis in RA is more advanced than in controls. Prospective studies are required to confirm that RA is an independent risk factor for peripheral arterial disease.
Kimon S Stamatelopoulos; George D Kitas; Christos M Papamichael; Katerina Kyrkou; Evangelia Zampeli; Kalliopi Fragiadaki; Vasileios F Panoulas; Myron Mavrikakis; Petros P Sfikakis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-12
Journal Detail:
Title:  Atherosclerosis     Volume:  212     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  305-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, 80, Vassilissis Sofias Ave, PO Box 11528, Athens, Greece.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Arthritis, Rheumatoid / blood,  epidemiology*
Asymptomatic Diseases
Atherosclerosis / blood,  drug therapy,  epidemiology*,  ultrasonography
Biological Markers / blood
C-Reactive Protein / analysis
Carotid Artery Diseases / blood,  drug therapy,  epidemiology*,  ultrasonography
Case-Control Studies
Chi-Square Distribution
Cholesterol, HDL / blood
Femoral Artery* / ultrasonography
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Logistic Models
Middle Aged
Peripheral Arterial Disease / blood,  drug therapy,  epidemiology*,  ultrasonography
Risk Assessment
Risk Factors
Severity of Illness Index
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Cholesterol, HDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 9007-41-4/C-Reactive Protein

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