Bone Abstracts

Introduction: In rheumatoid arthritis (RA) patients subclinical atherosclerosis and cardiovascular events (CV) occur more frequently and at younger ages than in the general population. Previous data suggest that heterogeneous plaques on USA are more unstable and frequently contain a higher amount of lipids and which make them hypoechoic and had higher potential for embolization and thrombosis. The aim of our work was to estimate the prevalence and the ultrasound morphology of carotid plaques in a cohort of RA patients without previous CV events.

Methods: 69 RA women who fulfilled the ACR criteria and 44 controls, age-matched, free of clinically CV disease underwent clinical evaluation (demographics, CV risk factors, RA characteristics, and medication) and carotid artery Doppler ultrasound. RA patients with and without plaques were compared and plaque morphology and location were analyzed.

Results: Mean age of the RA women was 47.7±13.5 years, mean disease duration of 7.7±6.2 years, 26.1% had hypertension, 23.2% dyslipidemia, 1.4% diabetes, 20.3% were smokers and the BMI was 27.78±5.1 kg/m². Eleven RA women (15.9%) presented at least one carotid plaque, while in controls plaques were found in five cases (11.36%). RA patients with plaques were older than those without plaques (60.0 vs 46.5; P=0.013) and had a higher intima-media thickness (IMT) (0.084 vs 0.035; P=0.0). Most RA patients had plaques of type 4 (homogeneous, hyperechoic); in controls the plaques were of types 2 (heterogeneous hypoechoic, 50%) and 4 (50%). In both were found in primitive carotid bifurcation.

Conclusion: RA is a pro-atherogenic state where other determinants beyond traditional CV risk factors remain to be identified. In this group women with plaques are at greater risk due to age and the presence of traditional CV risk factors and we found interesting differences regarding the type of plaques in RA and controls.