Von Willebrand Factor and Intima-Media Thickness in Patients With Rheumatoid Arthritis: A Cross-Sectional Study

Abstract

Background. Cardiovascular risk assessment in patients with rheumatoid arthritis (RA) is often a real challenge and requires the search for new indicators to reveal the potential threat of developing atherosclerotic vascular lesions in the early stages.
 The study aimed to analyse the association between von Willebrand factor (vWF), disease activity, and intima-media thickness (IMT) score in RA patients.
 Materials and Methods. The study involved 60 RA patients divided into three groups based on the Disease Activity Score 28 (DAS-28) activity index and 20 individuals as healthy controls. Clinical and laboratory assessments included determining the number of swollen (SJ) and painful joints (PJ), the visual analogue scale (VAS) score, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen. The concentration of vWF in blood plasma was determined by an enzyme-linked immunosorbent assay (ELISA). The IMT was measured at the bifurcation of the external and internal carotid arteries. Asymptomatic vascular damage was identified as the IMT > 0.9 mm; an atherosclerotic plaque was verified when a focal structure encroached ≥ 0.5 mm or 50% of the adjacent IMT value into the carotid lumen or the IMT > 1.5 mm.
 Results. Most RA patients (39/60; 65.0%) showed an increase in the IMT (> 0.9 mm); atherosclerotic plaques (IMT > 1.5 mm) were confirmed in 16 (26.7%) individuals, which was significantly more as compared to the control group. VWF was positively associated with the IMT [OR 1.1 (1.06-1.2), p < 0.001]. In addition, elevated levels of vWF were associated with disease activity. The highest values of vWF were found in patients with moderate RA activity (43.3 [21.2-56.9]). There was a positive correlation between vWF and ESR, CRP, DAS-28 (0.564, 0.455, and 0.573, respectively).
 Conclusions. There was a positive correlation between vWF, inflammatory markers, and disease activity. VWF appeared to be a reliable predictor of the IMT score in RA patients.