Article Figures & Data
Figures
- Figure 1
Number of carotid plaques in patients with rheumatoid arthritis (RA) and non-RA controls; carotid plaques shown as percentage of total number of patients and controls. Difference between groups: Poisson regression adjusted for age and sex, p < 0.001.
- Figure 2
Characteristics of carotid artery plaque according to disease activity in patients with rheumatoid arthritis (RA) and controls. Different methods were used to compare patients and controls and trend within RA disease activity: mixed models with random intercepts were used to analyze plaque area and GSM; Poisson regression analysis was used to compare number of plaques between patients and controls. All data were adjusted for age, sex, smoking, and systolic blood pressure and are presented as least-square means with standard error. Trend analyses were performed by linear contrasts within each model. #RA vs controls; †trend in RA disease activity. CDAI: Clinical Disease Activity Index; SDAI: Simplified Disease Activity Index; DAS28: Disease Activity Score based on 28-joint counts; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; Ctr: controls; Rem: remission; LDA: low disease activity; MDA: moderate disease activity; HDA: high disease activity; GSM: Gray-Scale Median.
Tables
- Table 2
Characteristics of patients with rheumatoid arthritis according to disease activity measures.
CDAI SDA I DAS28 Remission LDA MDA + HDA MDA + HDA vs Remission Remission LDA MDA + HDA MDA + HDA vs Remission Remission LDA MDA + HDA MDA + HDA vs Remission ≤ 2.8 > 2.8 and ≤ 10 > 10 p ≤ 3.3 > 3.3 and ≤ 11 > 11 p < 2.6 ≥ 2.6 and ≤ 3.2 > 3.2 p No. patients 43 71 31 43 68 34 78 27 40 Age, yrs, median (IQR) 64.1 (55.7–72.6) 63.5 (54.0–70.9) 60.0 (51.0–65.7) 0.07 61.7 (53.6–69.2) 63.5 (54.0–70.9) 60.4 (51.7–68.6) 0.53 62.4 (53.2–70.4) 63.5 (54.4–69.8) 61.7 (53.6–72.2) 0.91 Sex, female/male 30/13 (69.8/30.2) 55/17 (76.4/23.6) 25/6 (80.6/19.4) 0.29 31/11 (73.8/26.2) 50/18 (73.5/25.5) 29/6 (82.9/17.1) 0.34 55/23 (70.5/29.5) 23/5 (82.1/17.9) 32/8 (80.0/20.0) 0.27 Cardiovascular risk factors Smoking ever-never 27 (62.8) 50 (69.4) 18 (58.1) 0.81 25 (59.5) 48 (70.6) 21 (60.0) 0.84 54 (69.2) 17 (60.7) 24 (60.0) 0.41 Systolic BP, mm Hg 131.3 ± 20.2 136.3 ±21.3 133.7 ± 18.4 0.60 130.9 ± 20.5 134.9 ± 19.8 137.1 ± 21.5 0.20 132.1 ± 20.3 135.8 ± 18.3 137.5 ± 21.8 0.19 Diastolic BP, mm Hg 79.1 ± 10.0 80.7 ± 9.6 81.1 ± 9.3 0.38 79.1 ± 9.7 80.2 ± 10.1 81.9 ± 8.6 0.18 79.2 ± 10.2 82.0 ± 9.3 81.4 ± 8.5 0.22 Diabetes 1 (2.3) 8 (11.1) 4 (12.9) 0.08 1 (2.4) 7 (10.3) 5 (14.3) 0.06 6 (7.7) 1 (3.6) 6 (15.0) 0.22 Body mass index, kg/m2 25.2 ± 3.7 26.0 ± 5.5 26.3 ± 4.9 0.27 25.6 ± 4.2 26.1 ± 5.4 25.7 ± 4.8 0.92 25.7 ± 4.4 26.2 ± 6.0 26.0 ± 5.0 0.74 Familial CVD 6 (14.0) 8 (11.1) 4 (12.9) 0.98 5 (11.9) 9 (13.2) 4 (11.4) 0.99 10 (12.8) 3 (10.7) 5 (12.5) 0.94 CVD measures CVD 3 (7.0) 12 (16.7) 6 (19.4) 0.10 3 (7.1) 11 (16.2) 7 (20.0) 0.09 10 (12.8) 2 (7.1) 9 (22.5) 0.16 Intima-media thickness, mm 0.76 ± 0.16 0.79 ± 0.20 0.74 ± 0.18 0.65 0.77 ± 0.16 0.78 ± 0.20 0.76 ± 0.19 0.92 0.77 ± 0.17 0.76 ± 0.17 0.78 ± 0.22 0.80 Patients with carotid plaques 23 (53.5) 49 (68.1) 14 (45.2) 0.48 22 (52.4) 45 (66.2) 18 (51.4) 0.93 48 (61.5) 15 (53.6) 23 (57.5) 0.67 No. carotid plaques 1.95 ± 0.98 2.08 ± 0.98 2.00 ± 1.11 0.90 1.86 ± 1.04 2.04 ± 0.93 2.17 ± 1.10 0.38 1.85 ± 0.90 2.07 ± 1.03 2.39 ± 1.08 0.37 No. GSM plaques Lipids 1.94 ± 1.03 1.92 ± 0.95 1.83 ± 0.94 0.78 2.00 ± 1.13 1.82 ± 0.80 1.94 ± 1.12 0.88 1.85 ± 0.91 1.73 ± 0.90 2.09 ± 1.06 0.37 Total cholesterol 6.1 ± 1.3 5.7 ± 1.2 5.2 ± 1.1 0.001 6.1 ± 1.2 5.7 ± 1.3 5.3 ± 1.1 0.006 5.8 ± 1.4 5.79 ± 1.1 5.47 ± 1.1 0.22 HDL cholesterol 1.8 ± 0.6 1.8 ± 0.6 1.7 ± 0.6 0.38 1.8 ± 0.6 1.8 ± 0.6 1.7 ± 0.5 0.49 1.8 ± 0.7 1.8 ± 0.6 1.7 ± 0.5 0.26 Triglycerides, median (IQR) 1.1 (0.8–1.5) 1.1 (0.8–1.5) 1.1 (0.8–1.7) 0.66 1.1 (0.8–1.5) 1.1 (0.8–1.5) 1.1 (0.8–1.6) 0.82 1.1 (0.7–1.5) 1.1 (0.9 –1.5) 1.1 (0.7–1.6) 0.69 LDL cholesterol 3.7 ± 1.0 3.3 ± 1.0 2.9 ± 1.0 0.001 3.7 ± 1.1 3.3 ± 1.0 3.0 ± 1.1 0.005 3.4 ± 1.1 3.4 ± 1.0 3.2 ± 1.0 0.39 Inflammatory markers ESR, mm/h, median (IQR) 11.0 (6.0–18.0) 13.0 (8.0–26.5) 13.0 (5.0–26.0) 0.40 10.0 (6.8–17.0) 13.0 (8.0–25.8) 17.0 (6.3–29.0) 0.03 9.0 (6.0–14.0) 14.0 (8.0–19.5) 26.0 (13.5–34.0) < 0.001 CRP, mg/dl, median (IQR) 2.0 (1.0–4.0) 4.0 (2.0–9.0) 4.0 (2.0–11.0) 0.003 2.0 (1.0–3.3) 4.0 (2.0–8.0) 7.0 (3.0–21.0) < 0.0001 3.0 (1.0–4.0) 3.0 (1.0–8.0) 7.5 (3.3–19.0) < 0.001 -
Demographic data are presented as crude data, compared using Student 2-sample T-test, Mann-Whitney U test, and chi-square test as appropriate. Skewed variables were log-transformed. Median values are given as mean ± SD, numbers (%), skewed data as median with interquartile range (IQR). CDAI: Clinical Disease Activity Index; SDAI: Simplified Disease Activity Index; DAS28: Disease Activity Score based on 28-joint counts; LDA: low disease activity; MDA: moderate disease activity; HDA: high disease activity; BP: blood pressure; CVD: cardiovascular disease; GSM: Gray-Scale Median (lipids are mmol/l); HDL: high-density lipoprotein; LDL: low-density lipoprotein; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein.
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Characteristic RA, n = 152 Controls, n = 89 p Age, yrs, median (IQR) 62.7 (53.6, 71.2) 55.7 (44.3, 63.1) < 0.001* Sex female, n (%) 116 (76.3) 54 (60.7) 0.01 Cardiovascular risk factors Smoking (ever), n (%) 97 (63.8) 56 (62.9) 0.94 Systolic blood pressure, mm Hg 134.5 ± 20.1 124.8 ± 18.1 0.07 Diastolic blood pressure, mm Hg 80.5 ± 9.6 76.4 ± 10.5 0.14 Diabetes, n (%) 14 (9.2) 2 (2.2) 0.12 Body mass index, kg/m2 25.9 ± 5.0 25.4 ± 4.0 0.25 Waist circumference, cm 88.4 ± 14.1 86.8 ± 12.7 0.15 Familial cardiovascular disease, n (%) 19 (12.5) 19 (21.3) 0.08 Cardiovascular disease markers Intima-media thickness, mm 0.8 ± 0.2 0.7 ± 0.2 0.39 Patients with carotid plaque, n (%) 90 (59.2) 24 (27.0) < 0.001 No. carotid plaques, median (IQR) 1 (0, 2) 0 (0, 1) < 0.001 Area of carotid plaques, mm2 16.5 ± 8.1 17.3 + 10.9 0.77 Gray-Scale Median value 89.3 ± 28.1 102.6 + 23.1 0.12 Lipids Total cholesterol, mmol/l 5.7 ± 1.2 5.8 + 1.0 0.009 HDL cholesterol, mmol/l 1.8 ± 0.6 1.7 ± 0.5 0.11 Triglycerides, mmol/l, median (IQR) 1.1 (0.8, 1.5) 1.0 (0.8, 1.5) 0.43 LDL cholesterol, mmol/l 3.3 ± 1.1 3.5 ± 0.9 0.02 Inflammatory markers, median (IQR) ESR, mm/h 13.0 (7.3, 21.8) 8.0 (6.0, 15.0) 0.21 CRP, mg/l 4.0 (1.0, 8.0) 1.0 (1.0, 2.0) < 0.001 Medication use, n (%) Statins 27 (17.8) 13 (14.6) 0.74 Hypertension medications 56 (36.8) 18 (20.2) 0.40 DMARD 100 (65.85) Tumor necrosis factor inhibitors 32 (21.1) Prednisolone 51 (33.6) Methotrexate 50 (32.9) Disease characteristics Disease duration, yrs, median (IQR) 17 (15, 19) Rheumatoid factor-positive, n (%) 77 (50.7) ACPA-positive, n (%) 75 (49.3) 28 Tender joint count 2.3 ± 3.9 28 Swollen joint count 1.9 ± 2.7 Physician VAS, cm 2.5 ± 1.6 Patient VAS, cm 3.3 ± 2.3 DAS28 2.6 ± 1.0 CDAI 6.9 ± 6.9 SDAI 7.7 ± 7.3 -
↵Data are means ± SD unless stated otherwise. P values are adjusted for age and sex using analysis of covariance (continuous variables), logistic regression for dichotomous variables, and Poisson regression for counts. Values for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and triglycerides were log-transformed for p value calculation. * Mann-Whitney U test (unadjusted). DMARD: disease-modifying antirheumatic drugs; ACPA: anticitrullinated protein antibodies; VAS: visual analog scale for disease activity; DAS:28: Disease Activity Score based on 28-joint count; IQR: interquartile range; HDL: high-density lipoprotein; LDL: low-density lipoprotein; CDAI: Clinical Disease Activity Index; SDAI: Simplified Disease Activity Index.
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Controls Patients with RA Measure Remission LDA MDA + HDA p, RA vs Controls Trend in RA Disease Activity 0.39 (0.19) CDAI 0.74 (0.17) 0.99 (0.13) 0.82 (0.20) < 0.0001 0.65 0.38 (0.19) SDAI 0.75 (0.17) 0.95 (0.14) 0.88 (0.19) < 0.0001 0.48 0.38 (0.19) DAS28 0.85 (0.13) 0.84 (0.20) 0.96 (0.17) < 0.0001 0.47 0.38 (0.19) CRP 0.78 (0.15) 0.97 (0.15) 0.89 (0.19) < 0.0001 0.54 0.38 (0.19) ESR 0.91 (0.16) 0.70 (0.17) 1.01 (0.15) < 0.0001 0.54 -
CDAI: Clinical Disease Activity Index, SDAI: Simplified Disease Activity Index; DAS28: Disease Activity Score based on 28-joint counts; LDA: low disease activity; MDA: moderate disease activity; HDA: high disease activity; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein.
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Controls Patients with RA Measure Remission LDA MDA + HDA p, RA vs Controls Trend in RA Disease Activity GSM 94.69 (6.80) CDAI 96.09 (6.31) 89.33 (4.52) 74.78 (7.44) 0.35 0.03 94.35 (6.71) SDAI 84.71 (6.51) 93.74 (4.59) 75.78 (6.77) 0.33 94.96 (6.72) DAS28 90.84 (4.65) 101.82 (7.96) 78.91 (5.48) 0.09 95.78 (7.05) CRP 84.89 (5.25) 88.13 (6.14) 93.40 (7.14) 0.31 96.41 (7.18) ESR 90.12 (6.96) 86.80 (7.26) 88.72 (4.89) 0.87 Minimum GSM 88.38 (6.64) CDAI 89.50 (7.09) 78.55 (5.11) 65.99 (8.17) 0.03 88.01 (6.64) SDAI 78.18 (7.34) 84.07 (5.27) 66.13 (7.48) 0.23 0.24 88.11 (6.58) DAS28 81.31 (5.23) 94.23 (8.73) 68.65 (6.22) 0.11 89.33 (7.03) CRP 74.50 (6.05) 82.94 (6.55) 79.13 (8.38) 0.63 89.33 (7.09) ESR 81.63 (7.32) 79.64 (7.99) 77.18 (5.71) 0.63 In area 2.82 (0.12) CDAI 2.62 (0.11) 2.75 (0.08) 2.80(0.13) 0.27 2.82 (0.12) SDAI 2.74 (0.11) 2.67 (0.08) 2.85 (0.12) 0.53 0.50 2.81 (0.12) DAS28 2.67 (0.08) 2.83 (0.14) 2.77 (0.09) 0.41 2.78 (0.12) CRP 2.85 (0.09) 2.59 (0.10) 2.68 (0.12) 0.23 2.83 (0.12) ESR 2.87 (0.12) (0.12) 2.68 2.67 (0.08) 0.54 -
CDAI: Clinical Disease Activity Index; SDAI: Simplified Disease Activity Index; DAS28: Disease Activity Score based on 28-joint counts; LDA: low disease activity; MDA: moderate disease activity; HDA: high disease activity; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein.
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