Inflammation predicts accelerated brachial arterial wall changes in patients with recent onset rheumatoid arthritis
Suad Hannawi
Arthritis Research & Therapy 2009, 11:R51doi:10.1186/ar2668
| Published: | 6 April 2009 |
Patients with recent onset rheumatoid arthritis (RA) have impaired brachial artery endothelial function compared to controls matched for age, sex, and cardiovascular risk factors. The present study examined endothelium-dependent (flow-mediated dilatation, FMD) and independent (GTN-mediated dilatation, GMD) structural responses in early RA patients, and determined progress over 1 year.
Brachial artery FMD and GMD and carotid intima media thickness (cIMT) were studied using ultrasound in 20 patients diagnosed with early RA in whom symptoms had been present for less than 12 months, and in 20 control subjects matched for age, sex and established cardiovascular risk factors. FMD and GMD were re-assessed after 12 months in RA patients and the change in each parameter was calculated. Data were analysed by univariate regression.
Mean FMD and GMD were significantly lower in early RA patients at baseline than in controls, but each parameter significantly improved in 1 year. FMD and GMD responses were positively associated with each other. Patients' age, CRP level and cIMT at baseline and CRP level at 1 year, were negatively associated with change in brachial responses in 1 year.
Patients with recent onset RA have altered brachial artery responses signifying both functional and structural abnormalities. However, early control of inflammation may reduce arterial dysfunction and thus the tendency for atherosclerotic progression.