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Early phase clinical and biological markers associated with subclinical atherosclerosis measured at 7 years of evolution in an early inflammatory arthritis cohort


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18

 

  1. Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France.
  2. Paris Descartes University, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.
  3. Paris Descartes University, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.
  4. Radiology Department, Rouen University Hospital, Rouen, France.
  5. Rheumatology Department, Amiens University Hospital, Amiens, France.
  6. Paris Diderot University, Bichat Claude-Bernard Hospital, Assistance Publique des Hôpitaux de Paris, France.
  7. Rheumatology Department, Amiens University Hospital, Amiens, France.
  8. INSERM UMR 1125 and Rheumatology Department, CHU Avicenne (APHP), Bobigny; and Department of Internal Medicine, Fondation A. De Rothschild, Paris, France.
  9. INSERM UMR 1125 and Rheumatology Department, CHU Avicenne (APHP), Bobigny, France.
  10. Inserm Unit 905, IRIB, Rouen University, Rouen, France.
  11. Rheumatology Department, Amiens University Hospital, Amiens, France.
  12. Radiology Department, Pauchet Hospital, Amiens, France.
  13. Rheumatology Department, Rouen University Hospital, Rouen, France.
  14. Rheumatology Department, Rouen University Hospital, Rouen, France.
  15. Biostatistics Department, Rouen University Hospital, Rouen, France.
  16. Biostatistics Department, Rouen University Hospital, Rouen, France.
  17. Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France.
  18. Rheumatology Department, CIC/CRB1404, Rouen University Hospital, and Inserm Unit 905, IRIB, Rouen University, Rouen, France. olivier.vittecoq@chu-rouen.fr

CER8244
2016 Vol.34, N°1
PI 0058, PF 0067
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PMID: 26744355 [PubMed]

Received: 26/12/2014
Accepted : 23/07/2015
In Press: 20/12/2015
Published: 10/02/2016

Abstract

OBJECTIVES:
Accelerated atherosclerosis has emerged as a critical issue in rheumatoid arthritis (RA). There is a need to better understand the link between RA and atherosclerosis. Our aim was to identify parameters associated with the development of subclinical atheroma in a very early arthritis (VErA) cohort.
METHODS:
VErA-cohort patients were prospectively recruited from 1998 to 2002. Arthritis treatment was standardised from onset. The clinical, biological and radiological parameters of all patients were collected from inclusion. Carotid intima-media thickness (cIMT) was measured 7 years after their first symptoms.
RESULTS:
Among 105 patients included, 82 developed RA (mean age at onset: 51.7±12.8 years). Mean carotid artery IMT at year 7 was 0.67±0.12 mm. Larger thickness defined by values above the median (0.66) was associated with inclusion age (p<10-6), swollen joint count (p=0.01), DAS44 (p=0.048) and hypertension (p=0.006). In contrast, anti-CCP positivity (>50 UA/ml) was associated with thinner cIMT (p=0.03). Baseline as well as cumulated values of markers reflecting systemic inflammation, lymphocyte activation, endothelial dysfunction and oxidative stress were not correlated with carotid subclinical atherosclerosis. Major independent atheroma risk factors retained by multivariate analyses were hypertension (OR 4.33 [1.59–11.73]; p=0.004) and swollen joint count at inclusion (OR 3.87 [1.54–9.72]; p=0.004), while methotrexate use was a protective marker (OR 0.27 [0.11–0.71]; p=0.007).
CONCLUSIONS:
This study conducted from the VErA vascular cohort of community-cases of RA confirm that cIMT is under the influence of classical CV risk (hypertension), disease marker (SJC) and methotrexate intake.

Rheumatology Article