Journal of the Bahrain Medical Society
Year 2018, Volume 30, Issue 3, Pages 34-41
https://doi.org/10.26715/jbms.3_28122018Arif Maldar*1, Suhas M1
1Department of General Medicine, Jawaharlal Nehru Medical College, KLES University, Nehru Nagar, Belagavi 590010, Karnataka, India.
*Corresponding author:
Arif Maldar, Department of General Medicine, Jawaharlal Nehru Medical College, KLES University, Nehru Nagar, Belagavi 590010, Karnataka, India; Tel: (+91) 9343227719, Email: arifmaldar@yahoo.com
Received date: December 6, 2018; Accepted date: December 28, 2018; Published date: December 31, 2018
Abstract
Background and objectives: Among several non invasive techniques available, a high-resolution B-mode ultrasonography is the widely used technique to measure carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA) patients with elevated cardiovascular risk. The present study was undertaken to explore the clinical relationship between CIMT and disease activity in patients with RA.
Methods: This study involved 50 adult patients with RA. Demographic, physical, systemic, and clinical data and history of the patients were recorded. Investigations, such as erythrocyte sedimentation rate, highly sensitive C-reactive protein, renal and liver function tests, RA factor, and anticyclic citrullinated peptide antibody tests were performed. CIMT was assessed using high resolution B-mode ultrasonography and the disease severity was assessed based on disease activity score (DAS) 28.
Results: The mean age of the RA patients was 49.88 ± 12.12 years with male predilection. The mean duration, mean European League Against Rheumatism (EULAR) criteria score, and mean DAS 28 score in RA patients were 3.62 ± 3.25 years, 8.10 ± 1.58, and 4.91 ± 1.11, respectively. The mean CIMT observed in RA patients was 0.94 ± 0.31 cm. Significant difference was observed in the mean CIMT values of different variables, including duration of joint pain (P = 0.007), tender joint count(P < 0.001), swollen joint count (P < 0.001), EULAR criteria score (P < 0.001), and DAS 28 score(P < 0.001). Also, CIMT correlated positively with tender joint count (r = 0.711; P < 0.001), swollen joint count (r = 0.673; P < 0.001), EULAR criteria score (r = 0.611; P < 0.001), and DAS 28 score (r = 0.729; P < 0.001).
Conclusion: A strong correlation was observed between CIMT and disease activity in patients with RA. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA.
Keywords: Atherosclerosis, carotid artery intima-media thickness, European League Against Rheumatism, High-resolution B-mode ultrasonography, rheumatoid arthritis