TY - JOUR

T1 - Atherosclerosis in rheumatoid arthritis versus diabetes

T2 - a comparative study

AU - Stamatelopoulos, Kimon S

AU - Kitas, George D

AU - Papamichael, Christos M

AU - Chryssohoou, Elda

AU - Kyrkou, Katerina

AU - Georgiopoulos, George

AU - Protogerou, Athanassios

AU - Panoulas, Vasileios F

AU - Sandoo, Aamer

AU - Tentolouris, Nikolaos

AU - Mavrikakis, Myron

AU - Sfikakis, Petros P

PY - 2009/10

Y1 - 2009/10

N2 - 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.

AB - 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.

KW - Arthritis, Rheumatoid

KW - Atherosclerosis

KW - C-Reactive Protein

KW - Cardiovascular Diseases

KW - Diabetes Complications

KW - Diabetes Mellitus

KW - Humans

KW - Logistic Models

KW - Prevalence

KW - Risk Factors

KW - Comparative Study

KW - Journal Article

U2 - 10.1161/ATVBAHA.109.190108

DO - 10.1161/ATVBAHA.109.190108

M3 - Article

C2 - 19608975

VL - 29

SP - 1702

EP - 1708

JO - Arteriosclerosis, thrombosis, and vascular biology

JF - Arteriosclerosis, thrombosis, and vascular biology

SN - 1079-5642

IS - 10

ER -