Abstract
Objective. We evaluated the predictive value of these vascular biomarkers for cardiovascular disease (CVD) events in patients with rheumatoid arthritis (RA): aortic pulse wave velocity (aPWV), augmentation index (AIx), carotid intima-media thickness (cIMT), and carotid plaques (CP). They are often used as risk markers for CVD.
Methods. In 2007, 138 patients with RA underwent clinical examination, laboratory tests, blood pressure testing, and vascular biomarker measurements. Occurrence of CVD events was recorded in 2013. Predictive values were assessed in Kaplan-Meier plots, log-rank, and crude and adjusted Cox proportional hazard (PH) regression analyses.
Results. Baseline median age and disease duration was 59.0 years and 17.0 years, respectively, and 76.1% were women. CVD events occurred in 10 patients (7.2%) during a mean followup of 5.4 years. Compared with patients with low aPWV, AIx, cIMT, and without CP, patients with high aPWV (p < 0.001), high AIx (p = 0.04), high cIMT (p = 0.01), and CP (p < 0.005) at baseline experienced more CVD events. In crude Cox PH regression analyses, aPWV (p < 0.001), cIMT (p < 0.001), age (p = 0.01), statin (p = 0.01), and corticosteroid use (p = 0.01) were predictive of CVD events, while AIx was nonsignificant (p = 0.19). The Cox PH regression estimates for vascular biomarkers were not significantly altered when adjusting individually for demographic variables, traditional CVD risk factors, RA disease-related variables, or medication. All patients who developed CVD had CP at baseline.
Conclusion. CP, aPWV, and cIMT were predictive of CVD events in this cohort of patients with RA. Future studies are warranted to examine the additive value of arterial stiffness and carotid atherosclerosis markers in CVD risk algorithms. Regional Ethical Committee approval numbers 2009/1582 and 2009/1583.
- RHEUMATOID ARTHRITIS
- PROJECTIONS AND PREDICTIONS
- ARTERIAL STIFFNESS
- CAROTID ARTERY PLAQUE
- CAROTID INTIMA-MEDIA THICKNESS
- CARDIOVASCULAR DISEASE
Footnotes
The establishment of the European Research on Incapacitating Diseases and Social Support and the Oslo Rheumatoid Arthritis Registry cohorts were supported in part by grants from the Research Council of Norway, the Lions Clubs International MD 104 Norway, the Norwegian Women’s Public Health Association, the Trygve Gythfeldt and Wife Legacy, the Grethe Harbitz Legacy, and the Marie and Else Mustad Legacy. The data collection in 2007 was supported by the Eastern Norway Regional Health Authority. Patients who took part in this study came from these cohorts.
- Accepted for publication May 3, 2016.