Carotid intima media thickness (Cimt) and its correlation with disease activity in rheumatoid arthritis

Abstract

Background: Rheumatoid Arthritis (RA) patients are at increased risk of cardiovascular disease (CVD), with majority of CVD mortality in RA are attributed to accelerated atherosclerosis. Systemic inflammation in RA plays an important role in accelerated atherosclerosis. CIMT is an early surrogate marker for early atherosclerosis. Aim: To determine the prevalence of thickened CIMT among RA patient and to study the correlation of CIMT and disease activity in RA Method: This was a cross sectional study involving 40 RA patients (mean 44.78 ± 13.18 years) without CVD risk factors and 40 healthy sex matched controls (mean 44 ±12.30 years). Their demographic profile, disease characteristics and medications were evaluated. Disease activity was measured with DAS28 CRP score. Carotid ultrasound was performed to determine presence of thickened CIMT, which was defined as thickness of more than 75th percentile matched for age-and sex-matched normal controls. Statistical analysis was performed to determine the correlation between disease activity and other factors associated with thickened CIMT. Results: The thickened CIMT was significantly greater in RA patients with moderate to high disease activity (DAS28 CRP >3.2) than in RA patients who were in remission or had low disease activity (50% n=6) vs (17.8% n= 5); p value 0.037. Otherwise, no significant difference in the prevalence of thickened CIMT found in RA compared to control group (27.5% n= 11) vs. (12.5% n=5); p value 0.09. There was also no significant correlation between age, disease durations, IL 17, CRP and seropositivity (RF) found with thickened CIMT. Conclusion: Among RA patients, thickened CIMT were associated with RA patient with active disease (DAS28 >3.2). However, there’s no significant difference in prevalence of CIMT between RA patients and healthy control found in our study.