POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

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AB0186 AT WHAT LEVEL SHOULD WE MEASURE INTIMA-MEDIA THICKNESS IN RHEUMATOID ARTHRITIS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4004 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1117.3-1118

Author(s):

L. Nacef ◽

H. Ferjani ◽

H. Riahi ◽

K. Maatallah ◽

Y. Mabrouk ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Internal Carotid ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

University Hospital ◽

External Carotid ◽

Media Thickness ◽

The Mean ◽

The Right ◽

Score Index

Background:Rheumatoid arthritis (RA) is chronic inflammatory rheumatism characterized by an independent cardiovascular (CV) risk. The screening of carotid intima-media thickness (IMT) in the common carotid artery appears to be a marker of atherosclerosis and is used as a specific tool for CV risk assessment.Objectives:The main of this study was to determine the most associated US sites with CV risk in RA.Methods:The present study is a prospective study conducted on Tunisian RA patients in rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected. The measurement of cIMTwas done using high-resolution B-mode carotid US with a Philips machine with the patient in supine position, according to AmericanSociety of Echocardiography guidelines.The carotid bulb below itsbifurcation and the internal and external carotid arteries were evaluated bilaterally with gray scale, spectral and color Doppler ultra-sonography using proprietary software for carotid arterymeasurements.IMT was measured using the two inner layers of the commoncarotid artery and an increased IMT was defined as ≥0.9 mm. The CV risk at 10 years was calculated by the SCORE index.Results:Forty-seven patients were collected, of which 78.7% were women. The mean age was 52.5 ±11.06 years. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients and diabetes in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The mean SCORE index of CV risk was 2±2.81 [0-11.6]. CV risk was significantly associated with the IMTs for LIC (p=0.029; r=0.374), LEC (p=0.04; r=0.480), and REC (p=0.016; r=0.408). No association was found between the IMT in the LCC (p=0,361; r=0,162), neither in the RCC (p=0,438; r=0,140) nor the RIC (p=0,670; r=0,077).Conclusion:In our study, IMT is strongly associated with score index, especially in carotid bifurcation. However, IMT measured in common carotid does not reflect a cardiovascular risk at 10-years.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.Disclosure of Interests:None declared

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Vascular geometry of the extracranial carotid arteries: an analysis of length, diameter, and tortuosity

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-011671 ◽

2015 ◽

Vol 8 (5) ◽

pp. 536-540 ◽

Cited By ~ 15

Author(s):

Farooq A Choudhry ◽

John T Grantham ◽

Ansaar T Rai ◽

Jeffery P Hogg

Keyword(s):

Carotid Artery ◽

Skull Base ◽

Aortic Arch ◽

Carotid Arteries ◽

Internal Carotid ◽

Men And Women ◽

Significant Difference ◽

The Common ◽

The Mean ◽

The Right

BackgroundStable access is essential for successful intracranial interventions. Quantifying variations in extracranial carotid arteries may help in the selection and development of access catheters. This study describes the vascular dimensions from the aortic arch to the skull base.MethodsCT angiography analysis was performed on 100 patients. The lengths, diameters, and tortuosity of the common carotid artery (CCA) and internal carotid artery (ICA) were measured from the aortic arch to the skull base.ResultsThe mean±SD length of the carotid artery from the aortic arch to the skull base was 22.2±2.2 cm for the right side and 20.8±1.9 cm for the left side (p<0.0001). The length of the right CCA was 13.6±1.2 cm and the length of the left CCA was 12.4±1.4 cm (p<0.0001). The length of the right ICA was 8.6±1.4 cm compared with 8.4±1.4 cm for the left ICA (p=0.3). The ICA length in men and women was 8.9±1.3 cm and 8.2±1.3 cm, respectively (p=0.0001), and the CCA length in men and women was 13.6±1.5 cm and 12.3±1.6 cm, respectively (p<0.0001). The lengths of the CCA and ICA in patients aged ≥60 years were 13.3±1.7 cm and 8.9±1.5 cm, respectively compared with 12.8±1.7 cm and 8.2±1.1 cm, respectively, for patients aged <60 years (p=0.04 for CCA, p=0.0002 for ICA). Tortuosity of the CCA and ICA was 1.2±0.2 and 1.3±0.1, respectively, in patients aged ≥60 years compared with 1.1±0.1 for both the ICA and CCA in patients aged <60 years (p<0.0001 for both). There was a consistent ratio of CCA/ICA length of 1.6±0.3 on the right and 1.5±0.3 on the left (p<0.0001). The arterial diameters did not show any significant difference.ConclusionsThe distance from the aortic arch to the skull base is longer on the right than on the left side. Both the CCA and ICA are longer in men and in patients aged ≥60 years. The tortuosity of both segments significantly increases with age.

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The relation between cardiovascular affection and erosive articular changes in patients with rheumatoid arthritis

QJM ◽

10.1093/qjmed/hcaa064.004 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M M H Hassabelnabi ◽

N Y Assaf ◽

H F Zidan ◽

G M M Abushanab

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Risk ◽

Power Doppler ◽

Premenopausal Women ◽

Joint Disease ◽

P Value ◽

Physical Medicine ◽

Bone Erosions ◽

The Mean

Abstract Background rheumatoid arthritis is currently regarded as independent cardiovascular risk factor. Accelerated atherosclerosis considered as an extra-articular manifestation of RA that occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators. Objectives the presented study aimed to find the relation between cardiovascular affection and erosive articular changes in RA. Subjects and Methods The presented study included 40 patients’ men and premenopausal women that were diagnosed with rheumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University, patients underwent laboratory investigation, carotid duplex, musculoskeletal ultrasound and echocardiography. Results Among 40 RA patients, 16 (40%) had erosions in both hands and 24 (60%) without erosion with no statistically significance difference between both sides of hand and feet, only 3 patients (7.5%) had active erosion exhibited by power Doppler. The presence of erosion positively correlated with the mean CIMT (p-value < 0.001) with mean 0.827±0.149, The presence of carotid plaques as a marker of advanced atherosclerosis showed statistically significant value with erosions (p = 0.001). There was positive relation between erosions with disease duration (p-value < 0.001), and negatively with DAS-28 (p = 0.083). Out of 33 patients with positive RF, 16 patients had erosions with statistically significant value (p = 0.017). Conclusion Since the presence of bone erosions was highly associated with higher mean CIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.

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High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

Advances in Rheumatology ◽

10.1186/s42358-019-0089-1 ◽

2019 ◽

Vol 59 (1) ◽

Cited By ~ 4

Author(s):

Maria Fernanda Brandão de Resende Guimarães ◽

Carlos Ewerton Maia Rodrigues ◽

Kirla Wagner Poti Gomes ◽

Carla Jorge Machado ◽

Claiton Viegas Brenol ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Laboratory Data ◽

Premature Cardiovascular Disease ◽

Prevalence Of Obesity ◽

The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

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FRI0250 SUBCLINICAL ATHEROSCLEROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS: COMPARABLE EFFECT OF TRADITIONAL CARDIOVASCULAR RISK FACTORS WITH RHEUMATOID ARTHRITIS

10.1136/annrheumdis-2019-eular.1845 ◽

2019 ◽

Author(s):

Hiurma Sánchez-Pérez ◽

Juan Carlos Quevedo-Abeledo ◽

Iñigo Rúa-Figueroa ◽

Beatriz Tejera-Segura ◽

Vanessa Hernández-Hernández ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Lupus Erythematosus ◽

Subclinical Atherosclerosis ◽

Systemic Lupus ◽

Comparable Effect

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Separate Origin of the Left Internal and External Carotid Artery from the Aortic Arch Associated with Contralateral Intracranial Giant Aneurysm

Interventional Neuroradiology ◽

10.1177/159101999900500310 ◽

1999 ◽

Vol 5 (3) ◽

pp. 261-263 ◽

Cited By ~ 2

Author(s):

G. Warschewske ◽

G. Benndorf

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Internal Carotid ◽

Similar Case ◽

Giant Aneurysm ◽

External Carotid Artery ◽

External Carotid ◽

The Common ◽

The Right ◽

Internal Carotid Arteries

One of the rare anomalies of the common carotid artery is the separate origin of the internal and external carotid artery. We present the case of a patient who was admitted to hospital for cerebral angiography to exclude an intracranial aneurysm. The DSA revealed a giant aneurysm of the right internal carotid artery and separate origins of external and internal carotid arteries from the aortic arch. To our best knowledge no similar case has previously been reported.

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Increased Prevalence of Carotid Artery Atherosclerosis in Rheumatoid Arthritis Is Artery-specific

The Journal of Rheumatology ◽

10.3899/jrheum.090670 ◽

2010 ◽

Vol 37 (4) ◽

pp. 730-739 ◽

Cited By ~ 41

Author(s):

HITOMI KOBAYASHI ◽

JON T. GILES ◽

JOSEPH F. POLAK ◽

ROGER S. BLUMENTHAL ◽

MARY S. LEFFELL ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Carotid Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Carotid Artery Atherosclerosis ◽

Carotid Bulb ◽

The Common ◽

Cv Disease ◽

The Right

Objective.Cardiovascular (CV) morbidity and mortality are increased in rheumatoid arthritis (RA). Prior investigations of the association of RA with measures of carotid atherosclerosis have yielded conflicting results. We compared carotid intima-media thickness (IMT) of both the common carotid (CCA) and proximal internal carotid (bulb-ICA) arteries, and plaque prevalence, between RA and non-RA participants.Methods.Subjects with RA were participants in a cohort study of subclinical CV disease in RA. Non-RA controls were selected from the Multi-Ethnic Study of Atherosclerosis. Both groups underwent B-mode ultrasonography of the right and left CCA and bulb-ICA. Linear regression was used to model the association of RA status with CCA and bulb-ICA-IMT, and logistic regression for the association of RA status with plaque.Results.We compared 195 RA patients to 198 non-RA controls. CV risk factors were similarly distributed, except for a higher prevalence of hypertension in the RA group. Mean adjusted bulb-ICA-IMT was higher in RA patients than controls (1.16 vs 1.02 mm, respectively; p < 0.001), while mean adjusted CCA-IMT did not differ significantly. After adjusting for CV risk factors, the odds of plaque were significantly increased in RA participants compared to controls (OR 2.41, 95% CI 1.26–4.61). The association of gender, age, smoking, and hypertension with bulb-ICA-IMT and plaque did not significantly differ by RA status. Interleukin 6 was strongly associated with bulb-ICA-IMT and plaque in controls but not in RA patients. In the RA group, shared epitope was associated with an increased prevalence of plaque.Conclusion.Compared to controls, RA was associated with a higher prevalence and higher severity of atherosclerosis in the bulb-ICA but not the CCA. Our data suggest that future studies in RA that utilize carotid artery measurements should include assessment of the bulb-ICA.

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Sensorineural Hearing Impairment and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients Without Traditional Cardiovascular Risk Factors

Archives of Rheumatology ◽

10.5606/archrheumatol.2016.5739 ◽

2016 ◽

Vol 31 (3) ◽

pp. 208-214

Author(s):

Hector Macias Reyes

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Hearing Impairment ◽

Subclinical Atherosclerosis ◽

Sensorineural Hearing ◽

Sensorineural Hearing Impairment

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Agenesis of the cervical internal carotid artery

The Journal of Laryngology & Otology ◽

10.1017/s0022215100109818 ◽

1989 ◽

Vol 103 (7) ◽

pp. 707-709 ◽

Cited By ~ 4

Author(s):

T. Nishimura ◽

T. Takimoto ◽

M. Kamide ◽

S. Ishikawa ◽

R. Umeda

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Radical Surgery ◽

Vascular Anomaly ◽

External Carotid Artery ◽

External Carotid ◽

Digital Subtraction ◽

Cervical Portion ◽

The Right

AbstractTotal or segmental agenesis of the internal carotid artery is a rare anomaly. The cervical portion of the internal carotid artery was absent in the right side of the patient who was carried out radical surgery due to recurrent oropharyngeal cancer. Post-operative venous digital subtraction angiography revealed that the remaining intracranial portion of the internal carotid artery was normally patent and supplied blood flow via ipsilateral external carotid artery. Otolaryngologist-Head and Neck surgeon should know such a vascular anomaly and avoid a disastrous result on dividing external carotid artery.

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