Measurement of the Common Carotid Arteries Intima-Media Thickness by Ultrasonography in Patients with Rheumatoid Arthritis

Purpose: Rheumatoid arthritis is a chronic inflammatory disabling disease affecting articular and extra articular organs and one of these important organs is cardiovascular system, whose involvement is a leading cause of morbidity and mortality of Rheumatoid arthritis patients. Therefore, it is important to look for the relation of Rheumatoid arthritis and the extent of cardiovascular involvement among those patients by Ultrasound (US) which is feasible, simple and low cost investigation. Moreover, sonographic measurement of carotid artery intimal thickness is one of those reliable and sensitive means in assessing generalized atherosclerosis. To determine whether arterial wall thickening is increased in Rheumatoid arthritis patients compared with healthy controls by measuring the intima-media thickness of the common carotid arteries and to evaluate the factors that may be responsible for arterial intima-media thickness increase in patients with Rheumatoid arthritis. Material and Methods: 32 Rheumatoid arthritis patients (7 males and 25 females) been evaluated for common carotid intima-media thickness compared with 30 healthy control subjects (8 males and 22 females) matched for (age, sex, and other major risk factors for atherosclerosis). Laboratory variables were measured by routine methods. Intima-media thicknesses of the common carotid arteries were measured by High-frequency linear probe ultrasound. Results: Common carotid artery intima-media thickness was significantly higher (P-value 0.003) in Rheumatoid arthritis patients (mean +/- SD 0.66 +/- 0.11mm) compared with controls (0.58 +/- 0.086mm). There was a highly significant association between carotid intima-media thickness increase and the acute phase reactants (ESR, CRP) and Rheumatoid factor as P-value was (0.000, 0.001 and 0.000) successively. No relation between carotid intima-media thickness and duration of disease modifying anti-rheumatic drugs usage was found (P-value 0.051). Conclusion: Rheumatoid arthritis patients are around three fold at a higher risk of developing arterial intimal thickening and in turn they are more prone to develop cardiovascular complications than normal population due to the effects of chronic inflammatory processes and these results concluded that the disease modifying anti-rheumatic drugs has no protective measures on arterial intima-media wall thickening.