Correlation of Carotid Intima Media Thickness with Disease Activity in Ankylosing Spondylitis

AbstractObjective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated.Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3±185.2 vs. 373.9±206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77±0.16 vs. 0.53±0.09 mm, respectively; p<0.001). While a statistically significant positive correlation was detected in all subjects between CIMT levels and ESR, CRP (r=0.378, p=0.002, r=0.547, p<0.001, respectively), no significant correlation was detected between serum ESM-1 levels and ESR, CRP, BASDAI, BASFI and CIMT.Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.

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Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis

International Journal of Rheumatology ◽

10.1155/2014/839135 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 13

Author(s):

Naveen Gupta ◽

Renu Saigal ◽

Laxmikant Goyal ◽

Abhishek Agrawal ◽

Rajat Bhargava ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Disease Activity ◽

Activity Index ◽

Surrogate Marker ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Study Groups ◽

Control Group ◽

Media Thickness ◽

Cardiovascular Morbidity And Mortality

Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study.Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels.Results. Mean age of the study groups was 29.43 ± 9.00 years. Average disease duration was 65.62 ± 54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62 ± 0.12 versus 0.54 ± 0.04;P<0.001). CIMT in the cases group positively correlated with age(r=0.357; P<0.05), duration of disease(r=0.549; P<0.01), and BASMI(r=0.337; P<0.05)and negatively correlated with ESR(r=−0.295; P<0.05).Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity.

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AB0234 ASSOCIATION OF HOMOCYSTEINE LEVEL AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2690 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1417.3-1417

Author(s):

D. Anghel ◽

L. Otlocan ◽

R. Bursuc ◽

E. Busuioc ◽

A. Manolache ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Homocysteine Level ◽

Intima Media Thickness ◽

Antiplatelet Agents ◽

Carotid Intima Media Thickness ◽

Tnf Alpha ◽

Das28 Score ◽

Media Thickness ◽

Alpha Therapy

Background:Homocysteine (Hcy) has been implicated in atherogenesis. High homocysteine level can predict cardiovascular events, including death. Atherosclerosis has a high incidence in patients with Rheumatoid Arthritis (RA).Objectives:The aim of this study is to evaluate the relationship between serum homocysteine levels and carotid atherosclerosis in patients with RA and anti-TNF therapy.Methods:Our study included 80 RA patients divided into two groups: 45 patients were with anti-TNF-alpha therapy (Adalimumab, Infliximab, Etanercept) and 35 RA patients with disease-modifying antirheumatic drugs (DMARDs). The patients were diagnosed with RA used ACR/EULAR 2010 Classification Criteria. We measured carotid intima-media thickness (CIMT) using high-resolution Doppler ultrasonography at baseline and then at 12 months. CIMT above 0.9 mm is an atherosclerosis marker. We considered high levels of homocysteine in the serum above 15 µmol/L. All patients had treatment with hypolipemiant drugs and antiplatelet agents during the 12 months. Other parameters were analyzed at baseline and after 12 months: age, lipid profile (HDL, LDL, and cholesterol), ESR and disease activity score (DAS28<2.6 means remission; DAS28=2.6-3.2 means low disease activity, DAS28=3.2-5.1 means moderate disease activity; DAS28>5.1 high disease activity).Results:45 patients received anti-TNF-alpha therapy (mean age 45.50±9.69 years) and 35 RA patients had treatment with DMARDs (mean age 48.3±8.9 years). High Hcy levels were found on 34% patients in DMARDs group and 21% patients in anti-TNF group. After 12 months of treatment, patients with high levels of Hcy and anti-TNF therapy had a significant decrease in CIMT. In patients with low Hcy level the decrease in CIMT was insignificantly statistic. In DMARDs group atherosclerotic plaque was detected to 26 patients (74.29%) and 21 (46.66%) patients were detected into anti-TNF group. After 12 months CIMT was significantly higher in DMARDs group and the difference was statistically significant compared to baseline and to anti-TNF group (p=0.0002). High DAS28 score was associated with increased CIMT and hyperhomocysteinemia in both groups (p=0.0001).Conclusion:Increased Hcy levels were associated with increased CIMT values in both groups. In RA patients with anti-TNF therapy and high Hcy levels, reduction of CIMT was statistically higher than in patients with DMARDs treatment.Disclosure of Interests:None declared

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No differences of carotid intima–media thickness between young patients with ankylosing spondylitis and healthy controls

Joint Bone Spine ◽

10.1016/j.jbspin.2007.11.007 ◽

2008 ◽

Vol 75 (5) ◽

pp. 548-553 ◽

Cited By ~ 44

Author(s):

Jung-Yoon Choe ◽

Myoung-Yong Lee ◽

Insoo Rheem ◽

Moo-Yong Rhee ◽

Sung-Hoon Park ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Young Patients ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Healthy Controls ◽

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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Correlation Between Carotid Intima-Media Thickness and the Activity of Rheumatoid Arthritis: A 1-Year Cross-Sectional Study

Journal of the Bahrain Medical Society ◽

10.26715/jbms.3_28122018 ◽

2018 ◽

Vol 30 (3) ◽

pp. 34-41

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Tender Joint Count ◽

Tender Joint ◽

Media Thickness ◽

Das 28 ◽

Significant Difference ◽

The Mean

Background and objectives: Among several noninvasive techniques available, a high-resolution B-mode ultrasonography is the widely used technique to measure carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA) patients with elevated cardiovascular risk. The present study was undertaken to explore the clinical relationship between CIMT and disease activity in patients with RA. Methods: This study involved 50 adult patients with RA. Demographic, physical, systemic, and clinical data and history of the patients were recorded. Investigations, such as erythrocyte sedimentation rate, highly sensitive C-reactive protein, renal and liver function tests, RA factor, and anticyclic citrullinated peptide antibody tests were performed. CIMT was assessed using highresolution B-mode ultrasonography and the disease severity was assessed based on disease activity score (DAS) 28. Results: The mean age of the RA patients was 49.88 ± 12.12 years with male predilection. The mean duration, mean European League Against Rheumatism (EULAR) criteria score, and mean DAS 28 score in RA patients were 3.62 ± 3.25 years, 8.10 ± 1.58, and 4.91 ± 1.11, respectively. The mean CIMT observed in RA patients was 0.94 ± 0.31 cm. Significant difference was observed in the mean CIMT values of different variables, including duration of joint pain (P = 0.007), tender joint count (P < 0.001), swollen joint count (P < 0.001), EULAR criteria score (P < 0.001), and DAS 28 score (P < 0.001). Also, CIMT correlated positively with tender joint count (r = 0.711; P < 0.001), swollen joint count (r = 0.673; P < 0.001), EULAR criteria score (r = 0.611; P < 0.001), and DAS 28 score (r = 0.729; P < 0.001). Conclusion: A strong correlation was observed between CIMT and disease activity in patients with RA. Hence, CIMT can be a useful surrogate marker for detecting atherosclerosis in patients with RA.

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Carotid Intima Media Thickness and Endothelial Function: Useful Surrogate Markers for Cardiovascular Risk in Rheumatoid Arthritis Patients

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1330953 ◽

2021 ◽

pp. 38-48

Author(s):

Riham A. El-Sehly ◽

Abeer A. Shahba ◽

Raghda G. Elsheik ◽

Mahmoud F. Selim

Keyword(s):

Rheumatoid Arthritis ◽

Endothelial Function ◽

Disease Activity ◽

Brachial Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

University Hospital ◽

Control Group ◽

Carotid Imt ◽

Media Thickness

Introduction: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in RA disease. In active RA patients, the majority of cardiovascular deaths result from accelerates atherosclerosis. Aim of the Work: The aim of this work is to assess carotid intima media thickness (C-IMT) and endothelial function by brachial artery flow mediated dilatation (FMD) in Rheumatoid arthritis patients and relation to the disease activity. Subjects and Methods: Our study included 50 RA patients, from Tanta University Hospital. 47 women and 3 men and their age ranged from 30-62 years. They were divided into group 1: 25 active RA patients, group 2: 25 inactive RA patients who were diagnosed by American College of Rheumatology (ACR) revised criteria for diagnosis of RA 1987 and disease activity was evaluated using disease activity score 28(DAS28). Group 3: 25 normal subjects as a control group. We measured C-IMT and FMD in all groups. Results: By comparing the groups, we found that active RA patients had increased C-IMT compared to inactive rheumatoid arthritis patients and controls which is indicator of atherosclerosis. FMD of the brachial artery impaired in RA patients compared to controls which is indicator of endothelial dysfunction. There was highly statistically significant relation between duration, activity of RA disease and atherosclerosis in RA patients. Conclusion: With increasing the frequency of atherosclerosis in asymptomatic RA patients, carotid IMT increased and FMD impaired when compared with general population. Active RA patients have increased carotid IMT and impaired FMD compared with inactive RA patients.

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