Characteristics and clinical associations of arterial stiffness and subclinical atherosclerosis in patients with rheumatoid arthritis

Abstract

The aim of the study was to evaluate parameters of arterial stiffness (AS) (carotid-femoral pulse wave velocity (cfPWV), central pulse pressure (PP), cardio-ankle vascular index (CAVI) and stiffness gradient between aorta and brachial artery) and subclinical athero-sclerosis (carotid intima-media thickness (CIMT) and ankle-brachial index (ABI)) according to inflammatory activity in patients with RA. Materials and methods: 85 patients with RA (EULAR/ACR 2010) were examined (age 59,7±14,3 years, 64,7% with arte-rial hypertension (AH). Median duration of RA was 7 years. PWV and central pulse wave were assessed by applanation tonometry. Arterial stiffness gradient was calculated as a ratio between carotid-femoral and carotid-radial PWV: its elevation ≥1 was considered as arterial stiffness mismatch. ABI and CAVI were measured by sphygmometry. CIMT was assessed according to the standard pro-tocol, CIMT≥0,9 mm was considered as a subclinical marker of atherosclerosis. p<0.05 was considered significant. Results. Presence of at least 1 marker of atherosclerosis was observed in 32,9%, at least 1 marker of AS – in 63,5%, any marker of arterial damage – in 65,9%. Groups with at least 1 marker of AS or atherosclerosis were characterized by significantly higher hs-CRP level (median 12,6 vs 5,9 mg/l and 11,3 vs 3,9 mg/l respectively). Presence of at least 1 marker of atherosclerosis was associated with age ≥58 (β =0,7) and stiffness gradient ≥1,1 (β =0,9), marker of AS – with GFR <62,1 ml/min/1,73 m 2 (β = – 0,5), dyslipidemia and NSAIDs intake. Spearmen analysis revealed significant positive correlations between hs-CRP and cfPWV (r=0,35), CAVI (r=0,42), ABI (r= – 0,3). Independent association of cfPWV elevation and hsCRP≥9,6 mg/l was found (β=0,18, р=0,04). Conclusion. In patients with RA markers of AS are more prevalent then markers of atherosclerosis. hsCRP is an independent marker of cfPWV increase as well as age, AH duration and SBP level.