A Study of Intima Media Thickness and Their Cardiovascular Risk Factors in Patients with Psoriatic Arthritis

Introduction: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32). Objective: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals. Methods: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients. Results: The positive IMT (IMT >1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean±SD of IMT was 0.725 ±0.260 mm for this study. Variables significantly associated with positive IMT (p<0.05) included age at the time of study (p=0.005), waist circumference (p=0.001), Hypertension (p=0.007), Diabetes (p=0.002) and Metabolic syndrome (p=0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p=0.032), with OR 1.116; 95 % CI (1.010–1.234). Conclusions: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08- 970-2125.

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Abstract P322: Soda Consumption is Associated With Carotid Intima-Media Thickness Among Middle-Aged Mexican Women

Circulation ◽

10.1161/circ.131.suppl_1.p322 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Mariel Arvizu ◽

Adriana Monge ◽

Martha Thamez ◽

Eduardo Ortiz-Panozo ◽

Elsa Yunes ◽

...

Keyword(s):

Cardiovascular Risk ◽

Subclinical Atherosclerosis ◽

Menopausal Status ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diet Change ◽

Sugar Sweetened Beverages ◽

Cross Sectional ◽

Media Thickness ◽

Sweetened Beverages

Introduction: Soda intake is associated with cardiovascular disease. Other sweetened drinks often considered healthy alternatives to sodas could have a similar impact on cardiovascular risk. Hypothesis: Sugar-sweetened beverages commonly consumed by Hispanics have a negative influence on cardiovascular risk. Methods: We evaluated the cross-sectional relationship of sweetened beverages and common carotid intima-media thickness (CIMT) in 1,054 disease-free women without diabetes, high cholesterol, history of stroke and/or myocardial infarction, from the Mexican Teachers’ Cohort. Beverage intake was estimated from a validated food-frequency questionnaire in 2008 and 4 years later, CIMT measurements were performed by neurologists. We defined subclinical atherosclerosis as CIMT ≥0.8mm or presence of plaque and beverage intake was categorized in quartiles of servings/day. Results: Mean (±SD) soda intake was 0.5 ± 0.7 servings/day among 45.2 ± 4.7 year old women and atherosclerosis prevalence was 8.7%. After adjusting for age, smoking, secondhand smoke, physical activity, oral contraception, menopausal status, SES, and diet, % change of CIMT per 1 serving/day of soda was 1.3 (95% CI 0.2-2.3). Comparing extreme quartiles of soda intake, we observed a 3.5% (95% CI 1.1-5.8; p-trend=0.003) increase in CIMT (Figure). Intake of artificially-sweetened soda, fruit infused water, and juice was not associated to CIMT. None of the beverages were associated to subclinical atherosclerosis. Conclusions: In this cross-sectional study, soda intake was associated to increased CIMT while artificially-sweetened soda, fruit water, or juice intakes were not. Our results support prior results on the adverse consequences of soda intake in cardiovascular health. Keywords: sugar-sweetened beverages, cardiovascular risk, intima media thickness, cross-sectional

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Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

European Journal of Epidemiology ◽

10.1007/s10654-021-00759-z ◽

2021 ◽

Author(s):

Eliana Portilla-Fernández ◽

Shih-Jen Hwang ◽

Rory Wilson ◽

Jane Maddock ◽

W. David Hill ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dna Methylation ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Association Studies ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

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AB0258 CAROTID INTIMA-MEDIA THICKNESS AND SERUM BIOMARKERS IN PARAGUAYAN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6520 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1428.2-1428

Author(s):

V. Valinotti ◽

A. Paats ◽

R. Acosta ◽

L. Roman ◽

I. Acosta-Colman ◽

...

Keyword(s):

Cardiovascular Risk ◽

Disease Duration ◽

Subclinical Atherosclerosis ◽

High Sensitivity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Serum Biomarkers ◽

Carotid Plaques ◽

Media Thickness ◽

Hs Crp

Background:The mechanism of increased cardiovascular risk in RA is not well understood and is independent of traditional CV risk factors. Intima-media thickness of the common carotid wall measured by ultrasonogram is a safe and useful biomarker of early stage atherosclerosis that correlates with coronary involvement; and it correlates with severity and duration of disease. Several studies have shown a relationship between inflammation markers, endothelial dysfunction markers, and carotid involvement. (1)Objectives:To determine the presence of inflammation biomarkers and its relationship with subclinical atherosclerosis measured by carotid ultrasound, and with the clinical characteristics in patients with established Rheumatoid Arthritis (RA)Methods:Descriptive, cross sectional, prospective study, in a Paraguayan cohort of patients with RA meeting ACR/EULAR2010 criteria. This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the National Sciences and Technology Council (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, homocysteine, apolipoprotein, fibrinogen, and high sensitivity-CRP levels) and carotid ultrasound evaluation by a trained specialist, to evaluate subclinical atherosclerosis. Subclinical atherosclerosis was defined as carotid intima-media thickness (CIMT) >0,9mm and/or presence of carotid plaques. All patients signed informed consent. SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous, and p ≤ 0.05 for statistical significance.Results:100 patients were included, 87% were women, mean disease duration 130.9±102.64 months, 77% were RF positive, and 84.4% were ACPA positive, 43.4% had bone erosions, mean ESR-DAS28 was 3,42±1,1; 30% had remission criteria. 39% had extra-articular manifestations.Elevated serum biomarkers were found: fibrinogen >400 mg/dL 88.2%, high sensitivity-CRP (hs-CRP) >5mg/dL 42.9%, endothelin >2 ng/mL 20%, alpha-TNF >15,6 pg/mL 13.1%, E-selectin >79,2 ng/mL 6%. 25.3% had CIMT >0,9 mm and mean CIMT was 0.68±0.25mm. 27.14% had carotid plaques. Patients with CIMT>1mm had higher frequency of family history of arterial hypertension (p=0.006), greater mean disease duration (p=0.0007), hip circumference (p=0.014), blood pressure (SBP p=0.038, DBP p=0.027), HAQ levels (p=0,019) and hs-CRP levels (p=0.013), also lower mean height (p=0,04); while carotid plaques were related to higher homocysteine (p=0.026) and hs-CRP levels (p=0.024).Conclusion:A considerable percentage of patients had subclinical atherosclerosis. Patients with CIMT>0,9mm had a longer disease duration, higher HAQ levels, hip circumference, as well as higher BP. High levels of hs-CRP were more frequently related to the presence of subclinical atherosclerosisReferences:[1]Aday, A. targeting residual inflammatory risk: a shifting paradigm for atherosclerotic disease. Frontiers in cardiovascular medicine. 2019. 6:16.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6403155/pdf/fcvm-06-00016.pdfDisclosure of Interests:None declared

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Impact of Cardiovascular Risk Factors on Carotid Intima-Media Thickness and Degree of Severity: A Cross-Sectional Study

PLoS ONE ◽

10.1371/journal.pone.0144182 ◽

2015 ◽

Vol 10 (12) ◽

pp. e0144182 ◽

Cited By ~ 20

Author(s):

Lijie Ren ◽

Jingjing Cai ◽

Jie Liang ◽

Weiping Li ◽

Zhonghua Sun

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Media Thickness ◽

Degree Of Severity

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Relationship Between Metabolic Syndrome and Carotid Intima-Media Thickness: Cross-Sectional Comparison Between Psoriasis and Psoriatic Arthritis

Arthritis Care & Research ◽

10.1002/acr.22144 ◽

2013 ◽

Vol 66 (1) ◽

pp. 97-103 ◽

Cited By ~ 29

Author(s):

Yih Chang Lin ◽

Deepan Dalal ◽

Sarah Churton ◽

Danielle M. Brennan ◽

Neil J. Korman ◽

...

Keyword(s):

Metabolic Syndrome ◽

Psoriatic Arthritis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cross Sectional ◽

Media Thickness

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The evaluation of epicardial adipose tissue and carotid intima media thickness in patients with Behçet’s disease

Vojnosanitetski pregled ◽

10.2298/vsp200120095s ◽

2021 ◽

pp. 95-95

Author(s):

Gonca Sağlam ◽

Mehmet Turgut ◽

Oktay Gülcü

Keyword(s):

Adipose Tissue ◽

Disease Activity ◽

Epicardial Adipose Tissue ◽

Subclinical Atherosclerosis ◽

Laboratory Data ◽

Clinical Manifestations ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Control Group ◽

Media Thickness

Objective: Epidemiological studies indicate that cardiovascular disease is common in almost all patients diagnosed with autoimmune disease. This study aimed to examine whether Epicardial adipose tissue (EAT) and carotid intima media thickness (CIMT) differ among patients with Beh?et?s Disease (BD) and healthy individuals. Methods: A total of 40 healthy subjects as controls and 40 BD patients with musculoskeletal complaints were enrolled in this cross-sectional prospective study. Socio-demographic, clinical and laboratory data were obtained and compared between groups. Beh?et?s Disease Current Activity Form was used to assess disease activity. Both groups underwent echocardiography to measure EAT and CIMT. Results: The mean thickness of EAT (5.70?1.05; 2.50?0.61, respectively, p<0.001) and CIMT (0.68?0.05; 0.63?0.06, respectively, p: 0.002) were significantly increased in BD patients compared to the control group. A positive correlation was observed between EAT thickness and age (r:0.500, p:0.001), the duration of the disease (r:0.330, p<0.001), waist circumference (r:0.316, p: 0.013), and disease activity (r: 0.31, p<0.001) in the patient group. The CIMT was positively correlated with age (r: 0.594, p: 0.001) and the duration of the disease (r: 0.585, p: 0.001). Use of glucocorticoids or clinical manifestations (joint involvements, genital ulcer, skin lesions, inflammatory back pain and major organ involvement) of the patients were not found to be associated with EAT or CIMT. Conclusion: The thickness of EAT and CIMT are increased in patients with BD that are associated with disease activity. Echocardiographic measurement of EAT and CIMT is an objective, noninvasive and available method that can evaluate the risk of subclinical atherosclerosis in patients with BD.

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Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20191473 ◽

2019 ◽

Vol 6 (3) ◽

pp. 628

Author(s):

K. M. Prabhuswamy ◽

M. Virgin Joena

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Cross Sectional ◽

Media Thickness ◽

The Mean

Background: IMT assessment as a non-invasive imaging test is quite widely used especially among RA patients, the clinical applications of using such knowledge is scarce, hence study was conducted to compare the carotid artery intima-media thickness (CIMT) in patients with rheumatoid arthritis (RA) with healthy controls also to study the correlation between duration of rheumatoid arthritis, the activity of rheumatoid arthritis and other factors influencing (CIMT).Methods: In analytical cross-sectional study, of 80 participants of RA and 40 healthy controls, “DAS28” was used to assess disease activity. Carotid intima-media thickness assessed using carotid ultrasonography.Results: Mean age of the cases and controls was 43.9 and 44.38 years. Subjects with duration of disease <2 years, to 5 years and >5 years were 35%, 45% and 20%. The mean carotid intima-media thickness was 5.61mm in controls, and CIMT was 6.11mm in people below 2 years and 7.08 mm in people between 2 to 5 years and 8.00mm in people above 5 years which was statistically significant. The mean carotid intima-media thickness was 5.61mm controls and 6.86mm in people with low, 7.00mm in people with moderate and 6.95mm in people with high disease activity, which was statistically significant.Conclusions: Study findings revealed risk of increase in carotid intima-media thickness higher among RA patients in the later stages and can increase the patients’ susceptibility to cardiovascular events. The factors showing strong association with intimal medial thickness were the age and symptoms duration.

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Abstract P074: Restless Legs Syndrome and Carotid Intima-Media Thickness in Women

Circulation ◽

10.1161/circ.131.suppl_1.p074 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Karen Jacobo ◽

Adriana Monge ◽

Eduardo Ortiz-Panozo ◽

Elsa Yunes ◽

Andres Catzin-Khulmann ◽

...

Keyword(s):

Restless Legs Syndrome ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Mean Difference ◽

Lower Limbs ◽

Cross Sectional ◽

Restless Legs ◽

Media Thickness ◽

Increased Risk

Introduction: Restless legs syndrome (RLS) is a common chronic disorder characterized by an irresistible need to move the lower limbs that is usually worse in the evening and is associated with sleep disturbances. RLS has been associated with hypertension and has been proposed as a marker for increased cardiovascular risk. Hypothesis: Individuals with RLS have an increased common carotid intima-media thickness (cIMT) relative to individuals without RLS. Methods: We evaluated cross-sectional relation of RLS and cIMT in 1,147 disease-free Mexican women of the Mexican Teachers’ Cohort. In 2011, participants responded to a follow-up questionnaire that included standardized questions addressing the four minimal diagnostic criteria of the International Restless Legs Study Group. Participants were asked: “Do you have unpleasant leg sensations (like crawling, loss of sensation or pain) combined with restlessness and an urge to move your legs?”, “Do these symptoms occur only at rest?”, “Does moving improve these symptoms?”, “Are these symptoms worse in the evening or at night compared with the morning?” Women who answered yes to all the four questions were defined as having RLS. Between 2012 and 2013, a subsample of participants were invited for a clinical visit where neurologists assessed cIMT with an ultrasound. cIMT measurements were found to be reproducible in a substudy in 52 participants (intra-class correlation=0.89). We defined subclinical atherosclerosis as a cIMT ≥0.8 mm or the presence of plaque. Results: Among women with a mean age of 48.2 (SD±4.3), the prevalence of RLS was 14.2% (cases, 163). The age-adjusted mean difference of cIMT comparing participants with RLS to those without RLS was 0.009mm (95%CI -0.004 to 0.023). After further adjustment for diabetes, hypercholesterolemia, migraine, oral contraceptive use, menopause, smoking, body mass index, physical activity and alcohol, the mean difference of cIMT comparing participants with and without RLS was not statistically different (0.007mm; 95%CI -0.007 to 0.021). The prevalence of subclinical atherosclerosis was 27% (n=44) in those with RLS and 21.9% (n=215) in those without RLS. The age-adjusted OR comparing women with RLS to those without RLS was 1.23 (95%CI 0.83-1.82). In the multivariable model the OR remained non-significant (1.16, 95%CI 0.77-1.74). Conclusions: In this cross-sectional study in middle-aged women, RLS was not associated to cIMT. Our results do not support the observation that individuals with RLS are at an increased risk for cardiovascular disease.

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