AB0296 ARTERIAL STIFFNESS IN RHEUMATOID ARTHRITIS PATIENTS: DO DISEASE ACTIVITY AND DURATION OF ILLNESS MATTER?
Authors: Awalia Awalia, Satyadi Satyadi, Sony Wibisono, Joewono Soeroso
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Recent evidence has demonstrated that the increased risk of mortality in rheumatoid arthritis (RA) patients is largely related to cardiovascular disease (CVD). Overall, RA increases the risk of cardiovascular (CV) mortality by up to 50% for reasons which are insufficiently understood. Chronic inflammation may impair vascular function and lead to increase of arterial stiffness. Measurement of arterial stiffness provide an independent risk factor of CV mortality and morbidity. Brachial pulse-wave velocity (BPWV) is a reproducible method to estimate of arterial stiffness. Whether the disease activity or duration of illness has more contribution in arterial stiffness of RA patients is still controversial. <h3>Objectives</h3> To investigate the correlation of disease activity and duration of illness in RA patients with pulse-wave velocity as a measure of arterial stiffness, free of cardiovascular disease and risk factors. <h3>Methods</h3> RA patients aged 55 years-old or younger were screened for the absence of clinical cardiovascular disease or risk factors (diabetes mellitus, dyslipidemia, hypertension, chronic kidney disease, smoking, obesity, cancer, prolong infections, excessive steroid use, or other inflammatory diseases). Patients were subjected to full history taking, clinical examination, and laboratory investigations including serum lipid profile, CRP, and ESR. Then they were recorded for their brachial pulse-wave velocity using PWV Sphygmograph. <h3>Results</h3> There were 30 suitable patients (all were female, mean age was 44.17 ± 7.98 years-old, mean duration of illness was 1.88 ± 0.94 years). Average systolic blood pressure was 121.67 ± 7.46 mmHg, mean diastolic pressure was 74.00 ± 4.98 mmHg. Average body mass index was 22.43 ± 1.18. Mean DAS28-ESR was 3.29 ± 1.32, and mean DAS28-CRP was 3.30 ± 4.02. Average of BPWV was 14.44 ± 3.86 m/s. This study did not show any correlation between duration of illness and arterial stiffness (p=0.832). But it revealed moderate correlation between disease activity (either DAS28-ESR or DAS28-CRP) with arterial stiffness (r=0.441 with p=0.015 and r=0.501 with p=0.005). <h3>Conclusion</h3> This preliminary suggests that disease activity of RA is correlated with arterial stiifness free of cardiovascular disease or risk factors. But duration of illnes does not show any correlation with arterial stiffness as believed before, it may need more sample size to determine that. This findings support the importance of inflammation control in RA patients not just to improve quality of life but also to decrease cardiovascular mortality in RA. <h3>References</h3> [1] Klocke R, Cockcroft JR, Taylor GJ, Hall IR, Blake DR. Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis. Ann Rheum Dis2003; 62:414-418. [2] Provan SA, Angel K, Semb AG, Mowinckel P, Agewall S, Star D, Kvien TK. Early prediction of increased arterial stiffness in patients with chronic inflammation: A 15-year followup study of 108 patients with rheumatoid arthritis. The J of Rheumatol 2011; 38:606-612. [3] Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis2012; 71: 1524–1529. [4] Youssef G, Allam NT, Gaber W, Afifi A, Hesham D. Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study. The Egyptian Heart J 2018; 70: 35-40. <h3>Disclosure of Interests</h3> None declared