Carotid artery volumetric measures associate with clinical ten-year cardiovascular (CV) risk scores and individual traditional CV risk factors in rheumatoid arthritis; a carotid-MRI feasibility study

Lesley-Anne Bissell, Bara Erhayiem, Graham Fent, Elizabeth M A Hensor, Agata Burska, Helena Donica, Sven Plein, Maya H Buch, John P Greenwood, Jacqueline Andrews

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Common carotid artery intima-media thickness (CIMT), as measured by ultrasound, has utility in stratification of the accelerated cardiovascular risk seen in rheumatoid arthritis (RA); however, the technique has limitations. Carotid magnetic resonance imaging (MRI) is emerging as a useful research tool in the general population, but has yet to be applied in RA populations. Our objectives were to describe the utility of carotid artery MRI (carotid-MRI) in patients with RA in comparison to healthy controls and to describe the association with RA disease phenotype.

METHODS: Sixty-four patients with RA and no history of cardiovascular (CV) disease/diabetes mellitus were assessed for RA and CV profile, including homeostasis model assessment-estimated insulin resistance (HOMA-IR) and N-terminal pro-brain natriuretic peptide (NT-proBNP). All underwent carotid-MRI (3 T), and were compared to 24 healthy controls. Univariable analysis (UVA) and multivariable linear regression models (MVA) were used to determine associations between disease phenotype and carotid-MRI measures.

RESULTS: There were no significant differences in carotid arterial wall measurements between patients with RA and controls. Wall and luminal volume correlated with 10-year CV risk scores (adjusted as per 2017 European League Against Rheumatism (EULAR) guidance); rho = 0.33 (p = 0.012) and rho = 0.35 (p = 0.008), respectively, for Joint British Societies-2 risk score. In UVA, carotid-MRI volumetric measures predominantly were associated with traditional CV risk factors including age, ever-smoking and HOMA-IR (p < 0.05). Lower body mass index was associated with wall maximum thickness (r = - 0.25 p = 0.026). In MVA, age was independently associated with wall volume (B 1.13 (95% CI 0.32, 1.93), p = 0.007) and luminal volume (B 3.69 (95% CI 0.55, 6.83, p = 0.022), and RA disease duration was associated with luminal volume (B 3.88 (95% CI 0.80, 6.97), p = 0.015).

CONCLUSIONS: This study demonstrates the utility of carotid-MRI in RA, reporting an association between three-dimensional measures in particular and CV risk scores, individual traditional CV risk factors and RA disease duration. Carotid-MRI in RA is a promising research tool in the investigation of CVD.

Original languageEnglish
Pages (from-to)266
JournalArthritis Research & Therapy
Volume20
Issue number1
DOIs
Publication statusPublished - 3 Dec 2018

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid/diagnostic imaging
  • Blood Sedimentation
  • C-Reactive Protein/metabolism
  • Cardiovascular Diseases/diagnostic imaging
  • Carotid Artery, Common/diagnostic imaging
  • Carotid Intima-Media Thickness
  • Female
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging/methods
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain/metabolism
  • Peptide Fragments/metabolism
  • Reproducibility of Results
  • Risk Factors
  • Severity of Illness Index

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