Atherosclerosis in an Indian cohort of rheumatoid arthritis with low disease activity and its correlation with inflammatory markers

BackgroundPatients of rheumatoid arthritis (RA) have close association with an increased risk of cardiovascular disease. The earliest stage of atherosclerosis is exhibited by endothelial dysfunction, which is an expression of a systemic phenomenon.ObjectiveTo evaluate the effect of inflammation of RA on endothelial function and its correlation with inflammatory markers, in young patients RA with low disease activity and without traditional cardiovascular risk factors by measuring endothelial reactivity.MethodsFlow-mediated vasodilatation (FMV), assessed by non-invasive ultrasound on the brachial artery, was evaluated in 50 young to middle aged patients with RA (age between 18 and 55 years) with disease activity score ≤3.2, without overt cardiovascular disease, at the age of 50 years, and sex matched healthy controls.ResultsMean FMV was found significantly lower in RA patients than in controls ([4.03±1.9 vs. 8.7±1.7]%; P < 0.001), and it was inversely related to C-reactive protein level (r = −0.415; P < 0.01) expressed at the value measured at the time of ultrasound evaluation.ConclusionsRA patients, young to middle aged, having low disease activity, free from overt cardiovascular disease and cardiovascular risk factors, have an altered endothelial reactivity that seemed to be primarily related to the inflammatory state of the disease.