Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study

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  • Kimon S Stamatelopoulos
    Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, 80, Vassilissis Sofias Ave, Athens, Greece.
  • George D Kitas
  • Christos M Papamichael
  • Elda Chryssohoou
  • Katerina Kyrkou
  • George Georgiopoulos
  • Athanassios Protogerou
  • Vasileios F Panoulas
  • Aamer Sandoo
    Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.
  • Nikolaos Tentolouris
  • Myron Mavrikakis
  • Petros P Sfikakis

OBJECTIVE: The extent to which atherosclerosis is accelerated in chronic inflammatory diseases is not established. We compared preclinical atherosclerosis in rheumatoid arthritis with diabetes mellitus, a known coronary heart disease equivalent.

METHODS AND RESULTS: Endothelial function, arterial stiffness, carotid intima-media thickness, and analysis of atheromatous plaques were examined in 84 rheumatoid arthritis patients without cardiovascular disease versus healthy controls matched for age, sex, and traditional cardiovascular disease risk factors, as well as in 48 diabetes patients matched for age, sex, and disease duration with 48 rheumatoid arthritis patients. Rheumatoid arthritis duration associated with arterial stiffening, whereas disease activity associated with carotid plaque vulnerability. All markers of preclinical atherosclerosis were significantly worse in rheumatoid arthritis compared to controls, whereas they did not differ in comparison to diabetes despite a worse cardiovascular risk factor profile in diabetics. Both diseases were associated independently with increased intima-media thickness; rheumatoid arthritis, but not diabetes, was independently associated with endothelial dysfunction.

CONCLUSIONS: Preclinical atherosclerosis appears to be of equal frequency and severity in rheumatoid arthritis and diabetes of similar duration with differential impact of traditional risk factors and systemic inflammation. Cardiovascular disease risk factors in rheumatoid arthritis may need to be targeted as aggressively as in diabetes.


  • Arthritis, Rheumatoid, Atherosclerosis, C-Reactive Protein, Cardiovascular Diseases, Diabetes Complications, Diabetes Mellitus, Humans, Logistic Models, Prevalence, Risk Factors, Comparative Study, Journal Article
Original languageEnglish
Pages (from-to)1702-8
Number of pages7
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number10
Publication statusPublished - Oct 2009
Externally publishedYes
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