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Carotid intima-media thickness and narrowing in rheumatoid arthritis: impact of age, diabetes, and conventional risk factors

cardiology
epidemiology
evidence-based-medicine
internal-medicine
rheumatology

Abstract

Background

Rheumatoid arthritis (RA) is associated with increased cardiovascular risk, yet its independent impact on subclinical atherosclerosis remains uncertain. This study aims to investigate the prevalence of subclinical atherosclerosis by assessing carotid plaques using Doppler ultrasonography.

Methods

In this cross-sectional study, 73 RA patients and 78 healthy controls underwent carotid Doppler ultrasonography to assess intima-media thickness (IMT) and carotid narrowing. Non-parametric statistical analyses were used to compare demographic and clinical variables between groups.

Results

The median age was 55 years (IQR: 43–63) in the RA group and 61 years (IQR: 51–68) in controls (p = 0.012). No significant differences were observed in median right CCA IMT (RA: 0.070 mm [IQR: 0.060–0.081] vs. controls: 0.068 mm [IQR: 0.050–0.076]; p = 0.619) or left CCA IMT (RA: 0.065 mm [IQR: 0.051–0.079] vs. controls: 0.065 mm [IQR: 0.050–0.074]; p = 0.701). The prevalence of carotid narrowing was also similar (right CCA: 15.1% vs. 11.5%, p = 0.633). Among RA patients, age was significantly correlated with right CCA IMT (Spearman’s rho = 0.375, p = 0.001), and diabetes mellitus was associated with higher rates of right CCA narrowing (34.8% vs. 6.0%, p = 0.003).

Conclusion

Carotid IMT and narrowing did not differ significantly between RA patients and controls. In RA, increased age and diabetes mellitus—but not RA status alone—were the principal determinants of subclinical carotid atherosclerosis. These findings highlight the need for targeted cardiovascular risk assessment in RA patients.

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