High prevalence of asymptomatic calcium atherosclerosis in rheumatoid arthritis patients

Abstract

PURPOSE

Coronary artery (CA), aorta calcium score (CS) and carotid artery CS are greatly related to the risks of coronary heart disease (CHD) and stroke. MDCT is an accurate method to evaluate CS in CA, aorta and carotid artery. Purpose of this study is to evaluate prevalence and extent of CS in RA patients without CHD and stroke and compare with controls. METHOD AND MATERIALS

During one year period, continuous 85 RA patients confirmed by diagnostic criteria were enrolled in this study (mean age 54±12, 73 female). Meanwhile, controls were selected from a database of healthy volunteers (mean age 56±10, 70 female). Clinical information and related blood test results were collected at the same period. All subjects underwent 64MDCT CS scan. CS was measured in CA, carotid artery (common and internal carotid artery) and aorta (ascending and descending aorta). Student’s t test and Fisher’s exact test were used to compare significant difference. Adjusted odds ratios were obtained from logistic regression model after controlling for age, sex and BP. RESULTS

Cases and controls had matched age, sex and race. Significantly higher prevalence and extent of CS were noted in CA, aorta and carotid artery in RA group. Mean prevalence of CA, aorta and carotid artery CS in cases and controls were 34% vs 16% (p=0.01), 65% vs 12% (p<0.0001) and 19% vs 6% (p=0.02). Mean CS were 63±197 vs 11±39 (p=0.01) in CA, 168±549 vs 28±168 (p<0.0001) in aorta and 21±95 vs 7±34 (p=0.01) in carotid artery. 74% (n=63) of RA vs 26% (n=22) of controls (p<0.0001) found calcium atherosclerosis. When adjusted for age, sex and BP, RA increased 4.7, 5.4 and 19.4 risk folds to have calcium atherosclerosis in CA, carotid artery and aorta. Traditional CHD risk factors, special anti-RA drugs did no significantly affect on this status. CONCLUSION

Our results demonstrated a significantly higher prevalence and extent of calcium atherosclerosis in CA, aorta and carotid artery in RA patients without CHD and stroke than controls. CLINICAL RELEVANCE/APPLICATION

RA is an independent risk factor of asymptomatic atherosclerosis in CA, aorta and carotid artery.