Study of Carotid Artery Intimomedial Thickness in Patients with Rheumatoid Arthritis and its Co-relation with Severity of the Disease.

Introduction: RA is a chronic inflammatory state, predisposing for atherosclerosis as it is an immunoinflammatory process. This study focuses on use of Carotid artery intimomedial thickness (CIMT) as a marker for subclinical atherosclerosis.

Objective: To study the assessment of atherosclerosis by Carotid Intimo-Medial Thickness (CIMT) in patients with rheumatoid arthritis and Correlation of ultrasonographic findings with severity of disease (using DAS-28 score).

Material And Methods: A prospective, case-control study involving 50 cases of diagnosed RA cases, and 50 healthy control. Sonological examination of the carotid and the vertebral arteries was done using a L&T SEQUINA color Doppler scanner with a linear band probe of frequency 6.6 to 14 MHz's.

Results: This case control study was carried out in 100 subjects (50 cases and 50 controls). Cases comprised of 41 rheumatic women (Mean age 42.08+12.13 yrs) and 9 (mean age 48.4+12.8 years) rheumatic men. Mean CIMT of the study group (0.5996+0.109mm) was significantly greater (p<0.001) than that of control group (0.5290+0.006mm). We observed carotid plaques in 18% subjects of study group compared to 2% in controls (p<0.001). Mean age in the study group was 46.56+12.82 years and that of controls was 46.38+11.69 years (p>0.05). In the study group mean CIMT was significantly increased in RA factor positive patients than in RA factor negative patients. We also calculated the DAS-28 score of the study group subjects and found that 8, 27 and 15 were having Mild, Moderate & severe disease activity respectively.

Conclusions: CIMT has significant correlation with the age, and CIMT increases with age. Mean CIMT was found to be more with RF+(ve) patients indicating acute inflammation also has a role. When compared, the mean CIMT in each DAS sub group the result was found to be statistically insignificant.