Purpose: Patients with rheumatoid arthritis and carotid plaque (CP) have been shown to have increased risk of future acute coronary syndrome. We have established a cardiovascular (CV) preventive clinic and in a CV risk evaluation it is of clinical value to know if CP is associated with coronary atherosclerosis (CA) in addition to the CV risk algorithms in patients with inflammatory joint diseases (IJD).
Objective: To evaluate if CP was associated with CA in patients with IJD.
Methods: In a preventive cardio-rheuma clinic 157 patients with IJD [98 with rheumatoid arthritis (RA), 42 with ankylosing spondylitis (AS), 17 with psoriatic arthritis (PsA)] were referred for CV risk evaluation. Traditional CV risk factors were recorded. All patients underwent B-Mode ultrasound of the carotid arteries for evaluation of CP and multidetector computer tomography (MDCT) coronary angiography for evaluation of CA.
Results: Patient characteristics as age, traditional CV risk factors and CRP/ESR were comparable across the various IJD, apart from gender (p<0.01) and disease duration (p<0.01). The presence of CP was also comparable across the various IJD [RA, n= 76 (77.6%), AS: 36 (85.7%), PsA 15 (88.2%), p=0.38]. A total of 98 (62.4%) had CA, while 59 (37.6%) did not have CA and there was no difference between the 3 IJD groups. In logistic regression analyses CP was significantly associated with CA (Table) independent of the 3 CV risk calculators: SCORE, Framingham and Reynolds. When number of CP was added in the models (Table), this increased the associations of CP with CA.
Conclusion: CP was independently associated with CA. CP can therefore be regarded as CV disease in patients with IJD and has direct clinical implications in CV risk evaluation and prevention.
