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Open Access Research article

Correlation between endothelial function and carotid atherosclerosis in rheumatoid arthritis patients with long-standing disease

Carlos González-Juanatey1, Javier Llorca2 and Miguel A González-Gay3*

Author Affiliations

1 Cardiology Division, Hospital Xeral-Calde, c/Dr. Ochoa s/n, Lugo E-27004, Spain

2 Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IFIMAV, Avenida Herrera Oria s/n, E-39011 Santander, Spain

3 Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Avenida de Valdecilla s/n, E-39008, Santander, Spain

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Arthritis Research & Therapy 2011, 13:R101  doi:10.1186/ar3382

Published: 22 June 2011

Abstract

Introduction

In this study, we aimed to determine the relationship between flow-mediated endothelium-dependent vasodilatation (FMD) and carotid artery intima-media wall thickness (IMT), two surrogate markers of atherosclerosis, in a series of Spanish patients with rheumatoid arthritis (RA) without clinically evident cardiovascular (CV) disease.

Methods

One hundred eighteen patients who fulfilled the 1987 American College of Rheumatology classification criteria for RA, had no history of CV disease and had at least one year of follow-up after disease diagnosis were randomly selected. Brachial and carotid ultrasonography were performed to determine FMD and carotid IMT, respectively.

Results

Carotid IMT values were higher and FMD percentages derived by performing ultrasonography were lower in individuals with a long duration from the time of disease diagnosis. Patients with a disease duration ≤ 7 years had significantly lower carotid IMT (mean ± SD) 0.69 ± 0.17 mm than those with long disease duration (0.81 ± 0.12 mm in patients with ≥ 20 years of follow-up). Also, patients with a long disease duration had severe endothelial dysfunction (FMD 4.0 ± 4.0% in patients with disease duration from 14.5 to 19.7 years) compared with those with shorter disease duration (FMD 7.4 ± 3.8% in patients with disease duration ≤ 7 years). Linear regression analysis revealed that carotid IMT was unrelated to FMD in the whole sample of 118 patients. However, carotid IMT was negatively associated with FMD when the time from disease diagnosis ranged from 7.5 to 19.7 years (P = 0.02).

Conclusions

In patients with RA without CV disease, endothelial dysfunction and carotid IMT increased with the duration of RA. The association between FMD and carotid IMT values was observed only in patients with long disease duration.