caa a22 4500 606239960 CHVBK 20210128101305.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00508-015-0767-x doi (NATIONALLICENCE)springer-10.1007/s00508-015-0767-x Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis? [Elektronische Daten] [Tolga Kurt, Ahmet Temiz, Ferhat Gokmen, Gurhan Adam, Sedat Ozcan, Ersan Ozbudak, Mustafa Sacar] Summary: Background: It takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. Methods: RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. Results: The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Conclusion: Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature. Springer-Verlag Wien, 2015 Rheumatoid arthritis nationallicence Carotid intima media thickness nationallicence Ankle brachial index nationallicence Kurt Tolga Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut Temiz Ahmet Department of Cardiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut Gokmen Ferhat Department of Physical Medicine and Rehabilitation, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut Adam Gurhan Department of Radiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut Ozcan Sedat Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut Ozbudak Ersan Department of Cardiovascular Surgery, School of Medicine, Kocaeli University, Kocaeli, Turkey aut Sacar Mustafa Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut Wiener klinische Wochenschrift Springer Vienna 127/13-14(2015-07-01), 529-534 0043-5325 127:13-14<529 2015 127 508 https://doi.org/10.1007/s00508-015-0767-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-015-0767-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kurt Tolga Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut NATIONALLICENCE 700 1- Temiz Ahmet Department of Cardiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut NATIONALLICENCE 700 1- Gokmen Ferhat Department of Physical Medicine and Rehabilitation, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut NATIONALLICENCE 700 1- Adam Gurhan Department of Radiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey aut NATIONALLICENCE 700 1- Ozcan Sedat Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut NATIONALLICENCE 700 1- Ozbudak Ersan Department of Cardiovascular Surgery, School of Medicine, Kocaeli University, Kocaeli, Turkey aut NATIONALLICENCE 700 1- Sacar Mustafa Faculty of Medicine, Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi dekanlık binası kat: 2 Kepez, Canakkale, Turkey aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/13-14(2015-07-01), 529-534 0043-5325 127:13-14<529 2015 127 508