POS0550 EVALUATION OF THE INTIMA-MEDIA THICKNESS INDEX BY CAROTID DOPPLER IN PATIENTS WITH RHEUMATOID ARTHRITIS AT HOSPITAL DOCENTE PADRE BILLINI, DOMINICAN REPUBLIC
Authors: T. Polanco Mora, J. Santana Peralta, A. Cornelio, Y. Cruz, E. Rodriguez Bautista, T. Valdez, R. Muñoz, A. Feriz
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis (RA) is an autoimmune disease systemic, affects 0.5 - 1% of the world population, predominantly female. (1) Carotid Doppler is used to detect endothelial dysfunction by measuring intima-media thickening, flow velocities, subclinical atherosclerosis markers, and vascular tone. (2,3) Measurement of carotid intima-media thickness (cIMT) is useful in assessing cerebrovascular disease and cardiovascular risk in patients with rheumatoid arthritis (4) Intima-media thickness value&gt; 0.9mm and presence of plaques Atheromatous cells in the carotid artery are predictive of increased cardiovascular risk and silent heart disease. (5.6) Objectives: To evaluate the carotid intima-media thickness in patients with rheumatoid arthritis Methods: A prospective, observational, cross-sectional study. Carotid Doppler was performed on outpatient patients with a diagnosis of rheumatoid arthritis from November 2019 to 2020 of the rheumatology service of the Hospital Docente Padre Billini and healthy controls. Inclusion criteria:&gt; 18 years, diagnosis of RA according to ACR / EULAR 2010 classification criteria, carotid Doppler with measurement of the carotid intima-media thickness. Controls without disease, matched by sex and age. The data were analyzed with SPSS V23. Results: Of 251 patients with a diagnosis of RA, 100 met criteria inclusion, 96.2% female, 100 healthy controls were included. Average evolution of the disease 7.5 years, 88%(88) Positive rheumatoid factor, 33% (33) Positive anti-CCP. 82% (82) concomitant scDMARD, 70% (70) bDMARD, 18% (18) ctDMARD. 53% (53) Dyslipidemia, 23% (23) obesity, 10% (10) hyperglycemia, 8% (8) smokers. DAS28 showed 57% (57) low activity, 20% (20) moderate activity, 15% (15) remission, 8% (8) high activity. Carotid Doppler in patients with RA showed 32% (32) atheromatous plaques, 18.75% (6) calcified plaques, 1.44% (1) stenosis bilateral carotid. C-reactive protein and erythrocyte sedimentation rate high 35% (35) / 58% (58) respectively. Carotid Doppler in healthy controls revealed 17% (17) atheromatous plaques, 47.05% (8) calcified plaques. 69% (69) of RA patients had increased cIMT, mean (SD) cIMT 3.82mm (1.11), controls 58% (58) increase in cIMT, Mean (SD) 3.12mm (0.93) (p = 0.0435). Conclusion: Our study showed that 69% of patients with Arthritis Rheumatoid featured increased intima-media thickness associated with low DAS28, we recommend assessing cardiovascular risk using carotid Doppler in patients with low to moderate activity. It was observed that in patients with RA and healthy controls more than half present increased carotid intima-media thickness. References: [1]JAMA. 2018;320(13):1360-1372. [2]Villa-Forte, B.F. Mandell / Rev Esp Cardiol. 2011;64(9):809–817. [3]Meune, C., Touzé, E., Trinquart, L., Allanore, Y. Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: A systematic review and meta-analysis of cohort studies. Rheumatology 2009; 48 (10): 1309-13. [4]Choi, HK., Rho, Y-H., Zhu, Y., Cea-Soriano, L., Aviña-Zubieta, JA., Zhang, Y. The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: A UK population-based outpatient cohort study. Ann Rheum Dis. 2013; 72 (7): 1182-7. [5]Gkaliagkousi, E., Gavriilaki, E., Doumas, M., Petidis, K., Aslanidis, S., Stella, D. Cardiovascular risk in rheumatoid arthritis: Pathogenesis, diagnosis, and management. J Clin Rheumatol Pract Rep Rheum Musculoskelet Dis. 2012; 18 (8): 422-30. [6]Corrales, A., González-Juanatey, C., Peiró, ME., Blanco, R., Llorca, J., González-Gay, MA. Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: Results of a population-based study. Ann Rheum Dis. 2013. Disclosure of Interests: None declared