Carotid Ultrasound May Help Identify Patients With RA at High-Risk for Subclinical Atherosclerosis

Patients with rheumatoid arthritis (RA) were associated with a higher prevalence of subclinical atherosclerosis within the first 5 years since their diagnosis; carotid ultrasound performed at RA diagnosis may help identify patients at high-risk, according to study findings published in Advances in Rheumatology.

Investigators assessed the prevalence of carotid plaque (CP) among patients with RA in the first 5 years since their diagnosis and evaluated disease characteristics associated with subclinical atherosclerosis.

A cross-sectional study was conducted, including patients with RA (aged 40-75 years) recruited within the first 5 years since their diagnosis. Patients with RA were matched 1:1 with healthy control individuals.

Detection of CP and carotid-intima media thickness (cIMT) were measured using carotid ultrasound.

A total of 60 patients with RA and 60 members of the control group were included in the analysis.

Patients with RA were mostly women (93%), mean disease duration was 2.66 years, median symptom duration was 3.41 years, and most patients were classified as having moderate disease activity; 73.3% of patients were treated with methotrexate therapy and 56.7% with glucocorticoids.

Patients with RA were associated with a higher prevalence of overall CP (30.0% vs 11.7%; P =.013), bilateral CP (18.3% vs 3.3%; P =.008), increased cIMT (30.0% vs 6.7%; P =.001), and increased subclinical atherosclerosis (53.3% vs 18.3%; P ≤.001), vs the control group.

Patients with RA and subclinical atherosclerosis vs those without subclinical atherosclerosis tended to be older (56.7 years vs 50.0 years; P =.002), had a higher prevalence of dyslipidemia (53.1% vs 14.3%; P =.002), and were more often classified as having moderate-high disease activity (68.8% vs 35.7%; P =.010).

According to binary logistic regression, the moderate-high disease activity classification category was independently associated with subclinical atherosclerosis (odds ratio, 6.11; 95% CI, 1.51-24.70; P =.011).

Study limitations included the small patient sample size and single-center, cross-sectional study design.

The study authors concluded, “The inclusion of the carotid ultrasound as part of the systematic [cardiovascular] evaluation of RA patients would allow the identification of high-risk patients who could benefit from preventive [cardiovascular] treatment.”