Abstract
Atherosclerosis is one of the most common complications of rheumatoid arthritis (RA). The objective of this study is to evaluate differences in large artery compliance (C1) and small artery compliance (C2) between RA and controls and evaluating factors associated with reduced compliance in the RA population. The profiling of large and small arterial compliance was analyzed in 185 RA patients and 88 healthy controls using Cardiovascular Profiling Instrument. The correlations of arterial compliance and the relevant clinical data were determined in these subjects. Then correlation analysis and regression analysis were performed to find whether rheumatoid arthritis patients have more risk factors than healthy controls in artery compliance and to explore the possible element involved in RA patients including traditional cardiovascular risk factors, RA disease-related factors, and the therapy. Compared with healthy controls, levels of C1 and C2 were significantly decreased in RA patients. Having adjusted the traditional risk factors associated with atherosclerosis, C1 and C2 decline was still a significant indicator in RA patients [odds ratio = 7.411(95%CI 3.275, 16.771) and 10.184(95%CI 4.546, 22.817)]. Using multi-factor regression analysis to adjust traditional risk factors for arterial compliance, we found that the levels of ESR was correlated with the abnormal large artery compliance [odds ratio = 1.021(95%CI 1.007, 1.035)]. The HAQ values and the current usage of leflunomide were correlated with the abnormal small artery compliance in RA patients [odds ratio = 1.161(95%CI 1.046, 1.289) and 6.170(95%CI 1.510, 25.215)]. The values of C1 and C2 are indicators of artery compliance in RA patients. ESR, HAQ values, and the usage of leflunomide might be possible risk factors of artery compliance. The evaluation of artery compliance could be an easy and reliable test that could help us to screen and predict cardiovascular disorders in RA patients.
Highlights
Rheumatoid arthritis (RA) is a common autoimmune disease involving multiple systems [1]
Compared with the healthy control group, C1 and C2 significantly reduced in the RA group, while proportions of abnormal large and small artery compliance increased significantly (p < 0.001) (Table 1)
By measuring the large artery compliance C1 and small artery compliance C2 of subjects using radial artery diastolic pulse waveform analyzer, this study confirms that the C1 and C2 indices are significantly lower in RA patients compared with the healthy control group
Summary
Rheumatoid arthritis (RA) is a common autoimmune disease involving multiple systems [1]. Atherosclerosis-induced cardiovascular disease (CVD) is one of the most common complications in patients with RA [2]. RA patients have significantly increased risk of atherosclerosis, earlier time of onset, higher mortality, and earlier time of death [3, 4]. Production of auto-antibodies and application of arthritis drugs can increase the risk of atherosclerosis in RA patients [7, 8]. Early detection of subclinical atherosclerosis in RA patients by simple, fast, noninvasive, low-cost method is of positive significance to the improvement of their prognosis
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