Relation of Endothelial Progenitor Cells and Carotid Intima Media Thickness in Indian Rheumatoid Arthritis Patients -A Cross Sectional Study.

Unlabelled: Carotid intima media thickness (CIMT), a surrogate marker for atherosclerosis, has been used to predict cardiovascular (CV) risk. Recently, endothelial progenitor cells (EPCs) have also garnered interest in its prediction. However a handful of studies, exploring this concept, have come out with disputed results. Notably, there are no Indian studies on this topic as well. Present study evaluates the relation of EPC with CIMT as a prelude to assess the capability of EPC as a marker for CV risk.

Material: This cross sectional pilot study enrolled 30 RA patients fulfilling the inclusion and exclusion criteria. Endothelial progenitor cells (CD34+ and CD45-) and CIMT were determined by flow cytometry and by a single radiologist respectively. The association between EPCs and CIMT was determined with the help of the Spearman correlation coefficient. A p-value < 0.05 was considered statistically significant.

Observation: The mean age of patients was 35.07 ± 10.09 years and the majority (83.3%) were females. The mean (SD) of EPC (%) and CIMT (mm) were 1.05 (0.98) and 0.60 (0.08) respectively. The correlation coefficient between CIMT and EPC was 0.76 (p = <0.001).

Conclusion: There was a significant positive correlation between EPCs and CIMT. CD34 positive and CD45 negative cells represent circulating endothelial cells rather than hematopoietic progenitor cells. Hence, increased levels of CD34+ and CD45-EPCs in RA patients may highlight atherosclerosis/endothelial damage and may be utilized for risk stratification just as higher CIMTs.