Sonographic Evaluation Of Subclinical Atherosclerosis In Chinese Rheumatoid Arthritis Patients Without Cardiovascular Risk Factors

Patients with RA are associated with increased mortality and the most common causeof mortality in RA is cardiovascular disease (CVD), with a relative risk of about2compared with age matched controls. Endothelial dysfunction mediated byinflammation is thought to be an early event in atherosclerotic process and has beenimplicated in future CVD in RA. A clinical useful tool indicating subclinicalatherosclerosis is to measure carotid artery intima-media thickness (CIMT) withultrasonography, providing early information of atherosclerosis and CVD. IncreasedCIMT is considered a marker of cardiovascular event and stroke in future. Anotherclinical useful tool indicating subclinical atherosclerosis is to assess flow-mediatedvasodilation (FMD) of brachial artery by high sensitivity ultrasonography. FMD isconsidered endothelium dependent vasodilation and an impairment of brachial arteryFMD is considered a marker of endothelial dysfunction. Although several studieshave reported increasing prevalence of subclinical atherosclerosis in RA as assessedby CIMT from other countries, little was known in Chinese RA patients. China hasexperienced a CV disease epidemic in recent decades and RA affects ranging from0.3to0.6%populations in China. Therefore we undertook this study in order toinvestigate the prevalence of subclinical atherosclerosis in Northern Chinese patients with RA. Furthermore, studies of the correlation between CIMT and brachial arteryFMD in different populations have produced different results, with some showing aninverse association between them, but others finding no relationship at all. So the aimof the current study was to evaluate the relationship between these two processes withclinical factors and the association between FMD%and CIMT in RA patients.