LBPS 02-11 ARTERIAL STIFFNESS IS ASSOCIATED WITH INFLAMMATORY ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

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Abstract

Objective:

Patients with rheumatoid arthritis (RA) are at higher risk of cardiovascular morbidity and mortality. Aortic stiffness (AS) is a predictor of cardio-vascular events. Chronic inflammation plays a role in the development of atherosclerosis in RA. Relationships between inflammation and AS in patients with RA are not well understood. The aim of the study was to evaluate parameters of AS and their associations with inflammatory activity in patients with RA.

Design and Method:

42 patients with RA (EULAR 2010) were examined (67%female, age 59.7 ± 15.2 years, 14% smokers, 60% with AH, 47% with dyslipidemia. Median duration of RA was 9 years (interquartile range (IQR)3–17). Seropositive RA was diagnosed in 42% of patients. All patients received disease-modifying antirheumatic drugs (DMARDs), 20% - biological treatment. hs-CRP and RF were assessed in all patients. AS was measured by applanation tonometry (SphygmoCor, AtCor) and cardio-ankle vascular index (CAVI) was assessed (VaSera1500).p < 0.05 was considered significant.

Results:

Median CRP was 13 mg/dl (IQR 3–24 mg/dl), median RF was 32 IU/ml (IQR8–165 IU/ml). Median PWV was 9.4 m/s (IQR7–11 m/s). PWV increase > 10 m/s was observed in 16 (37.8%) patients. Patients with PWV > 10m/s were older (72.0 ± 8.5 vs 53.3 ± 14.9 years), had higher BMI (30.5 ± 5.9 vs 24.9 ± 4.5 kg/m2) and longer duration of AH (median 14 years [IQR 7.5–18] vs 0 years [IQR 0–4.5]) and higher BP levels (143 ± 21/84 ± 9 vs 124 ± 13/78 ± 9 mmHg). They also had higher levels of LDL-C (3.0 ± 1.0 vs 4.1 ± 0.8 mmol/l), plasma glucose (5.6 ± 0.9vs4.9 ± 0.8 mmol/l), hs-CRP (median 9[IQR 2–17.1] vs 22[IQR 13–56.6] mg/dl) and CAVI (9.2 ± 0.5vs7.2 ± 1.2), p < 0.05 for trend. Spearmen analysis revealed positive correlations of PWV with age (r =0.65), BMI (r = 0.53), SBP (r = 0.62), DBP (r = 0.41), LDL-C (r = 0.60), glucose (r = 0.38), AH duration (r = 0.69) and hs-CRP (0.28), р < 0.05 for trend. Multiple regression analysis confirmed that age (β = 0.3, р = 0.0012), AH duration (β = 0.4, р = 0.0001), SBP (β = 0.42, р < 0.0001) and hs-CRP-level (β = 0.26, р = 0.0004) were independent predictors of AS increase.

Conclusions:

Inflammatory activity is a predictor of AS increase in patients with RA receiving DMADs.

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