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ORIGINAL ARTICLE
Year : 2013  |  Volume : 40  |  Issue : 1  |  Page : 56-61

Evaluation of carotid atherosclerotic changes in patients with rheumatoid arthritis


1 Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2 Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Menoufia University, Menoufia, Cairo, Egypt
3 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Cairo, Egypt
4 Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Cairo, Egypt

Correspondence Address:
Samar G. Soliman
Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Menoufia University, Menoufia, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


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Objective The aim of this study was to assess the presence of subclinical atherosclerosis in Egyptian rheumatoid arthritis (RA) patients and its correlation to disease activity. Patients and methods Thirty RA patients and 20 control individuals matched for age and sex were subjected to a full clinical assessment and laboratory investigations, including rheumatoid factor, erythrocyte sedimentation rate, C-reactive protein, total lipid profile, ECG, conventional radiography of the hands to detect joint erosion, and high-resolution B-mode ultrasound of the common carotid arteries for intima-media thickness (IMT) and carotid plaques. Results Patients with RA had increased carotid artery IMT compared with matched healthy controls. There were statistically significant differences between the studied RA patients and controls in serum cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein (P<0.001), but the selected patients with RA were not diagnosed as hyperlipidemic as their lipid profile level still did not exceed the normal average limits. In terms of carotid duplex parameters, there were significantly higher carotid IMT, interluminal diameter (ILD), and interadventetial diameter (IAD) in the 30 RA patients than in the 20 control participants (P<0.001); a higher prevalence of carotid atherosclerosis in the studied RA patients was found by measuring IMT more than 1.1mm and IAD more than 8.00 mm. There was a statistically significant positive correlation between disease activity score and carotid IMT (P<0.05), whereas no correlation was detected between disease activity score and carotid interluminal diameter or IAD in the RA patients studied. Conclusion RA is associated with accelerated atherosclerosis. Thus, aggressive treatment of RA patients and better monitoring of atherosclerotic risk factors are required to reduce cardiovascular morbidity and mortality.


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