Pattern on atherosclerosis for coronary, carotid and aortic arteries calcification in rheumatoid arthritis: a multidetector CT study

Abstract

Background: Multi-detector computed tomography (MDCT) measured coronary, carotid and aortic artery calcium score (CS) reflecting calcified atherosclerotic plaque (CAP) which are associated with coronary artery disease (CAD) and stroke. This study is designed to evaluate the prevalence and pattern of CS in asymptomatic rheumatoid arthritis (RA) patients compare with controls subjects. Methods: 85 age and sex matched RA patients (mean age 53.9±11.8) and controls (mean age 56.3±10.0) were enrolled. All subjects underwent 64MDCT scan to evaluate CS in coronary, carotid arteries and the aorta. Results: Presence of CAP were more prevalent in RA patients compared to controls in coronary artery (41% vs. 18%, p=0.013), carotid artery (19% vs. 6%, p=0.018) and aorta (64% vs. 12%, p<0.001). The prevalence of calcium was over 90% in RA patients at the age of 60 or above and in 55% of control subjects. After adjustment with age and sex, RA patients had a 5.0, 5.7 and 19.5 risk folds to have CAP in coronary, carotid and aortic artery. Aorta of RA patients had the highest frequency of CS > 0 (63.5%) compared with coronary artery in control subjects (11.8%) and this pattern remained the same upon age stratification (42.9-85.2% in RA patients and 4.2-34.5% in control subjects). Conclusions-RA patients have significantly higher prevalence and extent of CAP compared with age and sex matched controls. In addition, a significant different calcification pattern was noted between RA patients and control subjects.