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Int J Rheum Dis ; 22(1): 25-31, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30168277

RESUMO

Rheumatoid arthritis (RA) is a chronic, inflammatory disease closely linked with atherosclerosis. Recommended cardiovascular disease (CVD) integral evaluation includes screening for asymptomatic atherosclerosis plaques with carotid ultrasound (US). The aim of this study is to evaluate the carotid US characteristics, including carotid intima media thickness (cIMT) and carotid plaque (CP), and compare RA-patients and controls in a Mexican-mestizo population. METHOD: Prospective cross-sectional, observational study comparing RA-patients and matched controls without RA. Medical history and physical exam was performed in all subjects by a rheumatologist and two clinical blinded radiologists did the carotid US. Increased cIMT was defined as ≥0.9 mm. CP was defined as a focal narrowing ≥0.5 mm of the surrounding lumen or a cIMT ≥1.2 mm. Multivariable analysis was done comparing RA-patients and control subjects characteristics with carotid US. RESULT: In the final analysis 209 patients were included, 103 patients with RA and 106 controls. Bilateral CP was found more than twice in RA than controls (15.5% vs 6.6%). Unilateral CP was more common in either side evaluated, being heterogeneous plaques the most common in RA-patients. The prevalence of increased cIMT was found higher in RA-patients either in both sides (right 37.9% vs 15.1%, P = 0.00; left 43.7% vs 19.8%, P = 0.00) were statistically significant. CONCLUSION: It was confirmed that RA-patients have greater subclinical atherosclerosis represented in the carotid US measuring cIMT and CP as surrogates. RA-patients with subclinical atherosclerotic disease have more heterogeneous plaques characteristics.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Ultrassonografia Doppler em Cores , Adulto , Idoso , Artrite Reumatoide/etnologia , Artrite Reumatoide/patologia , Doenças Assintomáticas , Artérias Carótidas/patologia , Doenças das Artérias Carótidas/etnologia , Doenças das Artérias Carótidas/patologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Incidência , Indígenas Norte-Americanos , Masculino , México , Pessoa de Meia-Idade , Placa Aterosclerótica , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Fatores de Risco
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