RT Journal Article
SR Electronic
T1 Different Type of Carotid Arterial Wall Remodeling in Rheumatoid Arthritis Compared with Healthy Subjects: A Case-Control Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2261
OP 2266
DO 10.3899/jrheum.120617
VO 39
IS 12
A1 ALPER M. VAN SIJL
A1 KATJA VAN DEN HURK
A1 MIKE J.L. PETERS
A1 VOKKO P. VAN HALM
A1 GIEL NIJPELS
A1 COEN D.A. STEHOUWER
A1 YVO M. SMULDERS
A1 ALEXANDRE E. VOSKUYL
A1 JACQUELINE M. DEKKER
A1 MICHAEL T. NURMOHAMED
YR 2012
UL http://www.jrheum.org/content/39/12/2261.abstract
AB Objective. Rheumatoid arthritis (RA) is associated with an increased cardiovascular (CV) risk, but mechanisms behind this increased risk have not been fully elucidated. Carotid arterial remodeling is the change of structural properties in response to hemodynamic or metabolic factors aimed at keeping wall stress within certain limits. This process might become maladaptive when stress on the arterial wall increases beyond these limits. We investigated whether maladaptive carotid arterial remodeling is present in RA compared with control subjects. Methods. The 2 cohorts were 96 patients with RA and 274 healthy subjects, who were investigated cross-sectionally. Carotid intima-media thickness (cIMT) and interadventitial diameter (IAD) were assessed by B-mode carotid ultrasonography. Lumen diameter (LD), circumferential wall stress (CWS), and circumferential wall tension (CWT) were calculated. Linear regression analyses were used to investigate the association between presence of RA and carotid arterial remodeling. Results. Compared with healthy subjects, RA was associated with a 0.40 mm (9.3%) greater LD, 0.41 mm (7.8%) greater IAD, 10% higher CWS, and 8% higher CWT. The groups had comparable cIMT. Associations remained similar after exclusion of patients with prior CV disease and after adjustment for demographic factors and CV risk factors. Conclusion. RA is associated with maladaptive outward carotid arterial remodeling. These results are relevant because maladaptive outward remodeling is associated with plaque instability and rupture. These results indicate an alternative pathway, beyond the traditional CV risk factors, in RA that amplifies the CV risk.