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Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific.
J Rheumatol 2010; 37(4):730-9JR

Abstract

OBJECTIVE

Cardiovascular (CV) morbidity and mortality are increased in rheumatoid arthritis (RA). Prior investigations of the association of RA with measures of carotid atherosclerosis have yielded conflicting results. We compared carotid intima-media thickness (IMT) of both the common carotid (CCA) and proximal internal carotid (bulb-ICA) arteries, and plaque prevalence, between RA and non-RA participants.

METHODS

Subjects with RA were participants in a cohort study of subclinical CV disease in RA. Non-RA controls were selected from the Multi-Ethnic Study of Atherosclerosis. Both groups underwent B-mode ultrasonography of the right and left CCA and bulb-ICA. Linear regression was used to model the association of RA status with CCA and bulb-ICA-IMT, and logistic regression for the association of RA status with plaque.

RESULTS

We compared 195 RA patients to 198 non-RA controls. CV risk factors were similarly distributed, except for a higher prevalence of hypertension in the RA group. Mean adjusted bulb-ICA-IMT was higher in RA patients than controls (1.16 vs 1.02 mm, respectively; p < 0.001), while mean adjusted CCA-IMT did not differ significantly. After adjusting for CV risk factors, the odds of plaque were significantly increased in RA participants compared to controls (OR 2.41, 95% CI 1.26-4.61). The association of gender, age, smoking, and hypertension with bulb-ICA-IMT and plaque did not significantly differ by RA status. Interleukin 6 was strongly associated with bulb-ICA-IMT and plaque in controls but not in RA patients. In the RA group, shared epitope was associated with an increased prevalence of plaque.

CONCLUSION

Compared to controls, RA was associated with a higher prevalence and higher severity of atherosclerosis in the bulb-ICA but not the CCA. Our data suggest that future studies in RA that utilize carotid artery measurements should include assessment of the bulb-ICA.

Authors+Show Affiliations

Divisions of Rheumatology, Cardiology, and Immunogenetics, Department of Medicine, and Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20110515

Citation

Kobayashi, Hitomi, et al. "Increased Prevalence of Carotid Artery Atherosclerosis in Rheumatoid Arthritis Is Artery-specific." The Journal of Rheumatology, vol. 37, no. 4, 2010, pp. 730-9.
Kobayashi H, Giles JT, Polak JF, et al. Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific. J Rheumatol. 2010;37(4):730-9.
Kobayashi, H., Giles, J. T., Polak, J. F., Blumenthal, R. S., Leffell, M. S., Szklo, M., ... Bathon, J. M. (2010). Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific. The Journal of Rheumatology, 37(4), pp. 730-9. doi:10.3899/jrheum.090670.
Kobayashi H, et al. Increased Prevalence of Carotid Artery Atherosclerosis in Rheumatoid Arthritis Is Artery-specific. J Rheumatol. 2010;37(4):730-9. PubMed PMID: 20110515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific. AU - Kobayashi,Hitomi, AU - Giles,Jon T, AU - Polak,Joseph F, AU - Blumenthal,Roger S, AU - Leffell,Mary S, AU - Szklo,Moyses, AU - Petri,Michelle, AU - Gelber,Allan C, AU - Post,Wendy, AU - Bathon,Joan M, Y1 - 2010/01/28/ PY - 2010/1/30/entrez PY - 2010/1/30/pubmed PY - 2010/6/23/medline SP - 730 EP - 9 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 37 IS - 4 N2 - OBJECTIVE: Cardiovascular (CV) morbidity and mortality are increased in rheumatoid arthritis (RA). Prior investigations of the association of RA with measures of carotid atherosclerosis have yielded conflicting results. We compared carotid intima-media thickness (IMT) of both the common carotid (CCA) and proximal internal carotid (bulb-ICA) arteries, and plaque prevalence, between RA and non-RA participants. METHODS: Subjects with RA were participants in a cohort study of subclinical CV disease in RA. Non-RA controls were selected from the Multi-Ethnic Study of Atherosclerosis. Both groups underwent B-mode ultrasonography of the right and left CCA and bulb-ICA. Linear regression was used to model the association of RA status with CCA and bulb-ICA-IMT, and logistic regression for the association of RA status with plaque. RESULTS: We compared 195 RA patients to 198 non-RA controls. CV risk factors were similarly distributed, except for a higher prevalence of hypertension in the RA group. Mean adjusted bulb-ICA-IMT was higher in RA patients than controls (1.16 vs 1.02 mm, respectively; p < 0.001), while mean adjusted CCA-IMT did not differ significantly. After adjusting for CV risk factors, the odds of plaque were significantly increased in RA participants compared to controls (OR 2.41, 95% CI 1.26-4.61). The association of gender, age, smoking, and hypertension with bulb-ICA-IMT and plaque did not significantly differ by RA status. Interleukin 6 was strongly associated with bulb-ICA-IMT and plaque in controls but not in RA patients. In the RA group, shared epitope was associated with an increased prevalence of plaque. CONCLUSION: Compared to controls, RA was associated with a higher prevalence and higher severity of atherosclerosis in the bulb-ICA but not the CCA. Our data suggest that future studies in RA that utilize carotid artery measurements should include assessment of the bulb-ICA. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/20110515/Increased_prevalence_of_carotid_artery_atherosclerosis_in_rheumatoid_arthritis_is_artery_specific_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=20110515 DB - PRIME DP - Unbound Medicine ER -