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Background: The atherogenic index of plasma (AIP) is a novel marker to identify cardiovascular disease. Recently, it was reported that AIP is related to long-term cardiovascular disease risk in women with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).
Objectives: To evaluate if RA-patients with high AIP present a higher prevalence of carotid plaque in comparison to patients with RA and low AIP.
Methods: A cross-sectional and comparative study including RA-patients aged 40 to 75 who fulfilled the ACR/EULAR 2010 classification criteria for RA. Patients with previous cardiovascular disease were excluded. Carotid ultrasound was performed on all study participants. The presence of carotid plaque (CP) was defined as diffuse carotid intima-media thickness (cIMT) ≥1.2 mm or focal thickness ≥0.5 mm. Subclinical atherosclerosis was defined as the presence of CP or an increased cIMT (≥0.8mm). AIP was defined by log (TG/HDL-C) mg/dL, and level ≥0.21 was considered a high AIP. Patients were divided into two groups according to AIP levels. The distribution between groups was assessed with the Kolmogorov-Smirnov test. Comparisons with Chi-square or Fisher’s exact test and Student’s t-test or Mann Whitney’s U-test, accordingly. A p -value of ≤0.05 was considered statistically significant.
Results: A total of 144 patients with RA were included, most patients were women (n=133, 94%). There was no difference between sex, traditional cardiovascular risk factors, disease activity, or disease duration between patients with high AIP and those RA-patients with low AIP (Table 1). Prevalence of CP (37.5% vs 25.0%, p =0.106) and overall subclinical atherosclerosis (58.3% vs 62.5%, p =0.609) was similar between groups (Table 1). However, the prevalence of increased cIMT was higher in RA-patients with high AIP (29.2% vs 54.2%, p =0.002).
Conclusion: The prevalence of increased cIMT was higher in RA-patients and high atherogenic index of plasma (AIP). AIP could potentially be a useful marker for the early identification of patients with increased cIMT.
Demographic characteristics.
| Characteristics | RA patients with low AIP
| RA patients with high AIP
| p -value |
|---|---|---|---|
| Age, years, ± SD | 56.7 ± 9.7 | 55.8 ± 9.7 | NS |
| Women, n (%) | 71 (98.6) | 65 (90.3) | NS |
| Diabetes, n (%) | 12 (16.7) | 12 (16.7) | NS |
| Hypertension, n (%) | 24 (33.3) | 23 (31.9) | NS |
| Dyslipidemia, n (%) | 24 (33.3) | 21 (29.2) | NS |
| Active smoking, n (%) | 6 (8.3) | 9 (12.5) | NS |
| Time of evolution, years, median (IQR) | 8.4 (3.0-15.0) | 10.0 (4.1-17.8) | NS |
| DAS28-CRP, ± SD | 3.3 ± 1.3 | 3.2 ± 1.4 | NS |
| Carotid plaque, n (%) | 27 (37.5) | 18 (25.0) | NS |
| Unilateral CP, n (%) | 14 (19.7) | 10 (13.9) | NS |
| Bilateral CP, n (%) | 13 (18.3) | 8 (11.1) | NS |
| Hyperplasia cIMT, n (%) | 21 (29.2) | 39 (54.2) | 0.002 |
| Unilateral high cIMT, n (%) | 11 (15.5) | 25 (34.7) | 0.008 |
| Bilateral high cIMT, n (%) | 10 (14.5) | 14 (19.4) | NS |
| Subclinical atherosclerosis, n (%) | 42 (58.3) | 45 (62.5) | NS |
RA, rheumatoid arthritis; SD, standard deviation; IQR, interquartile range; NS, no significative; AIP, atherogenic index of plasma; DAS28-CRP, 28-joint Disease Activity Score based on C-reactive protein; CP, carotid plaque; cIMT, intima-media thickness.
REFERENCES: NIL.
Acknowledgements: NIL.
Disclosure of Interests: None declared.