Comparison of Carotid Ultrasound Parameters in Patients with Rheumatoid Arthritis and Control Subjects: A Cross-sectional Study

Abstract

Introduction: Rheumatoid Arthritis (RA) is considered one of the risk factors for Cardiovascular Disease (CVD). Carotid ultrasound is used to assess the extent of subclinical atherosclerosis in patients with RA. Very few studies have evaluated all carotid ultrasound findings, such as Carotid Intima-media Thickness (CIMT), carotid diameters like Luminal Diameter (LD) and Interadventitial Diameter (IAD), and plaque characteristics in patients with RA. Aim: To assess and compare the various carotid parameters in RA patients with controls and also to evaluate their association with age and duration of onset of the disease. Materials and Methods: A single-centre cross-sectional study was conducted at the Department of Radiology, GCS Medical College and Hospital, Ahmedabad, Gujarat, India, involving 40 patients with RA (Group-RA) and 40 controls (Group-C). Patients were further divided into three age subgroups. Carotid ultrasound parameters like CIMT, LD, IAD, and plaque were evaluated in both groups. Continuous variables were analysed using the t-test, and categorical data were analysed using the Chi-squared test. A p-value of < 0.05 was considered statistically significant. Results: Age- and sex-matched controls were included with 28 females and 12 males in both the study groups. The mean LD and IAD were significantly higher in the RA group than in controls (Mean LD- 5.88±0.97 mm vs 5.26±1.08 mm with p=0.009; Mean IAD- 6.85±0.89 mm vs 6.30±0.87 mm with p=0.006). The mean CIMT was higher in the RA group but not statistically significant (0.57±0.13 mm vs 0.54±0.12 mm with p=0.256). Further subgroup analysis showed that all carotid parameters were statistically significant in the 31-60 years age group as compared to 18-30 years and 61-80 years subgroups. The effect of the duration of the disease (>5 years) on the carotid parameters was also significantly higher in the 30-60 age group (p<0.001). Conclusion: The present study showed that various carotid ultrasound parameters can be used as a screening tool in the follow-up of RA patients to detect early changes in atherosclerosis, with LD and IAD having superior predictive capability. The study further showed that carotid ultrasound parameters have a better predictive value in the 31-60 years age group.