Imaging atherosclerosis in rheumatoid arthritis: evidence for increased prevalence, altered phenotype and a link between systemic and localised plaque inflammation
Journal article, 2017
In rheumatoid arthritis (RA), chronic inflammation is thought to drive increased cardiovascular risk through accelerated atherosclerosis. It may also lead to a more high-risk plaque phenotype. We sought to investigate carotid plaque phenotype in RA patients using Dynamic Contrast-Enhanced MRI (DCEMRI) and Fludeoxyglucose Positron Emission Tomography(FDG-PET). In this pilot study, RA patients and age/sex-matched controls were evaluated for cardiovascular risk factors and carotid plaque on ultrasound. Subjects with plaque >2 mm thick underwent DCE-MRI, and a subgroup of patients had FDG-PET. Comparison of MRI findings between groups and correlation between clinical, serological markers and imaging findings was undertaken. 130 patients and 62 controls were recruited. Plaque was more prevalent in the RA group (53.1% vs 37.0%, p = 0.038) and was independently associated with IL6 levels (HR[95% CI]: 2.03 [1.26, 3.26] per quartile). DCE-MRI data were available in 15 patients and 5 controls. Higher prevalence of plaque calcification was noted in RA, despite similar plaque size (73.3% vs 20%, p = 0.04). FDG-PET detected plaque inflammation in 12/13 patients scanned and degree of inflammation correlated with hs-CRP (r = 0.58, p = 0.04). This study confirms increased prevalence of atherosclerosis in RA and provides data to support the hypothesis that patients have a high-risk plaque phenotype.
Author
S. Skeoch
Christie Hospital NHS Foundation Trust
University of Manchester
Penny L Hubbard Cristinacce
University of Manchester
H. Williams
Christie Hospital NHS Foundation Trust
P. Pemberton
Christie Hospital NHS Foundation Trust
D. Xu
University of Washington
J. Sun
University of Washington
J. James
Christie Hospital NHS Foundation Trust
Chengyin Yuan
University of Washington
T. Hatsukami
University of Washington
Paul Hockings
Chalmers, Signals and Systems, Signal Processing and Biomedical Engineering
M. Y. Alexander
Manchester Metropolitan University
John C Waterton
University of Manchester
I. N. Bruce
University of Manchester
Christie Hospital NHS Foundation Trust
Scientific Reports
2045-2322 (ISSN) 20452322 (eISSN)
Vol. 7 1 827Subject Categories
Bioprocess Technology
Areas of Advance
Life Science Engineering (2010-2018)
DOI
10.1038/s41598-017-00989-w