Inflammation, carotid intima-media thickness and atherosclerosis in rheumatoid arthritis
1 School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, UK
2 Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Pensnett Road, Dudley, West Midlands DY1 2HQ, UK
Arthritis Research & Therapy 2008, 10:102 doi:10.1186/ar2345
See related research by Thomas et al., http://arthritis-research.com/content/9/6/R116, related letter by Gonzalez-Gay et al.,http://arthritis-research.com/content/10/3/403 and related response by Veldhuijzen van Zanten and Kitas, http://arthritis-research.com/content/10/3/404Published: 16 January 2008
Carotid intima-media thickness (cIMT) reflects early atherosclerosis and predicts cardiovascular events in the general population. An increased cIMT is present in patients with rheumatoid arthritis, compared with control individuals, from the early stages of the disease and is thought to indicate accelerated atherosclerosis, but direct evidence is not available. Whether cIMT is susceptible to rapid and potentially reversible change depending on the intensity of inflammation in states of high-grade systemic inflammation, such as rheumatoid arthritis, remains unknown. If this is the case, an increased cIMT in such disease states may not reflect structural vessel wall damage, and may not be a good predictor of future cardiovascular events in these particular populations. Prospective, long-term, longitudinal studies are needed to address these questions.