Carotid Intima-Media Thickness: An Index Early Detection of Subclinical Atherosclerosis in Rheumatoid Arthritis

Abstract

Background: Increased cardiovascular risk has been observed in patients with rheumatoid arthritis due to accelerated atherosclerosis. The significance of Carotid Intima-Media thickness as a surrogate marker for detecting subclinical atherosclerosis is uncertain.Objective: To assess the carotid intima-medial thickness (CIMT) in rheumatoid arthritis patients and to correlate it with the prognostic outcome of patients with rheumatoid arthritis(RA)Methods: In this cross-sectional study, 50 patients diagnosed with Rheumatoid arthritis (according to ACR-EULAR criteria)who presented to the hospital were recruited. Ultrasound B-mode examination of carotids and carotid intimamedial thickness measurement(CIMT) was carried out in these patients. Statistical software SPSS-15.0 was used for the analysis of the data. Descriptive and inferential statistical analysis was carried out.Results: Out of total 50 patients, 31 females (62%) and 19 patients males (38%), a total of 30(60%) had atherosclerotic changes on CIMT. These included 19 females(63.3%) and 11 males(36%). In female sub-group, atherosclerotic changes in left common carotid artery (68%) were predominant and right common carotid artery in male sub-group(64%). In case of atherosclerotic right common carotid artery(CCA) mean PSV, mean EDV and ,mean RI were found to be 55.48±9.37, 15.36±3.66 and 0.64±0.07 and in the left CCA, mean PSV, mean EDV and mean RI were 59.44±6.98, 16.80±4.48 and 0.64±0.08 respectively.EDV was found to be statistically significantly altered. There was no significant correlation between Doppler velocities in both right carotid and left carotid with Gender or age.Conclusion: Based on the findings of the study, it can be concluded that CIMT screening by B-mode Doppler USG scan is a useful surrogate marker for assessing subclinical atherosclerosis in patients with RA.