Usefulness of measuring common carotid intima-media thickness: Ultrasound diagnosis of sub-clinical atherosclerosis in rheumatic diseases. A literature review

Abstract

Abstract Introduction Patients with rheumatic diseases have an increased cardiovascular risk due to systemic inflammation and endothelial dysfunction, which promotes accelerated atherosclerosis. One way to measure cardiovascular risk, is through the carotid intima-media thickness which is an inexpensive and non-invasive predictor of cardiovascular events. Objective To examine the evidence to determine the usefulness of ultrasound in the diagnosis of sub-clinical atherosclerosis in rheumatic diseases assessed by carotid intima-media thickness (IMT). Material and methods A systematic literature search was performed, using electronic databases of PubMed, for articles published from January 2005 to May 2015, with no language restriction. Observational cohort studies that assessed the prevalence of sub-clinical atherosclerosis using the IMT were included. Results A total of 56 studies were identified for analysis, with almost all (95.7%) reporting an increased IMT in relation to the control group. Conclusions Patients with rheumatic diseases have an increased cardiovascular risk assessed using IMT. This measurement, assessed by carotid ultrasound, may help detect the risk of sub-clinical cardiovascular disease in these populations, allowing to establish a therapeutic strategy to reduce the risk of morbidity and mortality in these patients.