Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study

Patients with rheumatoid arthritis (RA) have a higher incidence of subclinical atherosclerosis and cardiovascular (CV) disease. It is postulated that the appearance of accelerated atherosclerosis in these patients is a consequence of the inflammation present in the disease. In this study, we aim to...

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Autores principales:	Iván Ferraz-Amaro, Alfonso Corrales, Belén Atienza-Mateo, Nuria Vegas-Revenga, Diana Prieto-Peña, Ricardo Blanco, Miguel Á. González-Gay
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	rheumatoid arthritis carotid plaque prospective study Medicine R
Acceso en línea:	https://doaj.org/article/12517df4f7514f7eb910d25b929658ff
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spelling	oai:doaj.org-article:12517df4f7514f7eb910d25b929658ff2021-11-11T17:36:26ZModerate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study10.3390/jcm102149752077-0383https://doaj.org/article/12517df4f7514f7eb910d25b929658ff2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4975https://doaj.org/toc/2077-0383Patients with rheumatoid arthritis (RA) have a higher incidence of subclinical atherosclerosis and cardiovascular (CV) disease. It is postulated that the appearance of accelerated atherosclerosis in these patients is a consequence of the inflammation present in the disease. In this study, we aim to determine if baseline disease activity in patients with RA predicts the future development of carotid plaque. A set of consecutive RA patients without a history of CV events, cancer or chronic kidney disease, who did not show carotid plaque in a carotid ultrasound assessment, were prospectively followed up for at least 5 years. At the time of recruitment, CV risk factors and disease-related data, including disease activity scores, were assessed. At the end of the follow-up, a carotid ultrasound was repeated and patients were divided into two groups; those who developed carotid plaque, and those who did not. A multivariable regression analysis was performed to define the predictors for the development of carotid plaque. One hundred and sixty patients with RA were followed up for an average of 6 ± 1 years. After this time, 66 (41%) of the patients had developed carotid plaque, and 94 (59%) did not. Patients with carotid plaque were significantly older (47 ± 13 vs. 55 ± 9 years, <i>p</i> < 0.001) at baseline, were more frequently diabetic (0% vs. 6%, <i>p</i> = 0.028), and had higher total cholesterol (197 ± 36 vs. 214 ± 40 mg/dL, <i>p</i> = 0.004) and LDL cholesterol (114 ± 35 vs. 126 ± 35 mg/dL, <i>p</i> = 0.037) at the beginning of the study. After multivariable adjustment, patients who were in the moderate and high disease activity (DAS28-CRP) categories displayed a higher odds ratio for the appearance of carotid plaque (OR 2.26 [95% CI 1.02–5.00], <i>p</i> = 0.044) compared to those in the DAS-28-CRP remission category. Remarkably, when patients were divided in patients within the low-risk SCORE category, and patients included in the remaining SCORE categories (moderate, high and very high), the relation between DAS28-CRP and the development of carotid plaque was only significant in the low-risk SCORE category. In conclusion, disease activity predicts the future development of subclinical atherosclerosis in patients with RA.Iván Ferraz-AmaroAlfonso CorralesBelén Atienza-MateoNuria Vegas-RevengaDiana Prieto-PeñaRicardo BlancoMiguel Á. González-GayMDPI AGarticlerheumatoid arthritiscarotid plaqueprospective studyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4975, p 4975 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis carotid plaque prospective study Medicine R
spellingShingle	rheumatoid arthritis carotid plaque prospective study Medicine R Iván Ferraz-Amaro Alfonso Corrales Belén Atienza-Mateo Nuria Vegas-Revenga Diana Prieto-Peña Ricardo Blanco Miguel Á. González-Gay Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
description	Patients with rheumatoid arthritis (RA) have a higher incidence of subclinical atherosclerosis and cardiovascular (CV) disease. It is postulated that the appearance of accelerated atherosclerosis in these patients is a consequence of the inflammation present in the disease. In this study, we aim to determine if baseline disease activity in patients with RA predicts the future development of carotid plaque. A set of consecutive RA patients without a history of CV events, cancer or chronic kidney disease, who did not show carotid plaque in a carotid ultrasound assessment, were prospectively followed up for at least 5 years. At the time of recruitment, CV risk factors and disease-related data, including disease activity scores, were assessed. At the end of the follow-up, a carotid ultrasound was repeated and patients were divided into two groups; those who developed carotid plaque, and those who did not. A multivariable regression analysis was performed to define the predictors for the development of carotid plaque. One hundred and sixty patients with RA were followed up for an average of 6 ± 1 years. After this time, 66 (41%) of the patients had developed carotid plaque, and 94 (59%) did not. Patients with carotid plaque were significantly older (47 ± 13 vs. 55 ± 9 years, <i>p</i> < 0.001) at baseline, were more frequently diabetic (0% vs. 6%, <i>p</i> = 0.028), and had higher total cholesterol (197 ± 36 vs. 214 ± 40 mg/dL, <i>p</i> = 0.004) and LDL cholesterol (114 ± 35 vs. 126 ± 35 mg/dL, <i>p</i> = 0.037) at the beginning of the study. After multivariable adjustment, patients who were in the moderate and high disease activity (DAS28-CRP) categories displayed a higher odds ratio for the appearance of carotid plaque (OR 2.26 [95% CI 1.02–5.00], <i>p</i> = 0.044) compared to those in the DAS-28-CRP remission category. Remarkably, when patients were divided in patients within the low-risk SCORE category, and patients included in the remaining SCORE categories (moderate, high and very high), the relation between DAS28-CRP and the development of carotid plaque was only significant in the low-risk SCORE category. In conclusion, disease activity predicts the future development of subclinical atherosclerosis in patients with RA.
format	article
author	Iván Ferraz-Amaro Alfonso Corrales Belén Atienza-Mateo Nuria Vegas-Revenga Diana Prieto-Peña Ricardo Blanco Miguel Á. González-Gay
author_facet	Iván Ferraz-Amaro Alfonso Corrales Belén Atienza-Mateo Nuria Vegas-Revenga Diana Prieto-Peña Ricardo Blanco Miguel Á. González-Gay
author_sort	Iván Ferraz-Amaro
title	Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
title_short	Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
title_full	Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
title_fullStr	Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
title_full_unstemmed	Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study
title_sort	moderate and high disease activity predicts the development of carotid plaque in rheumatoid arthritis patients without classic cardiovascular risk factors: six years follow-up study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/12517df4f7514f7eb910d25b929658ff
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Moderate and High Disease Activity Predicts the Development of Carotid Plaque in Rheumatoid Arthritis Patients without Classic Cardiovascular Risk Factors: Six Years Follow-Up Study

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