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 1 827

Subject Categories

Bioprocess Technology

Areas of Advance

Life Science Engineering (2010-2018)

DOI

10.1038/s41598-017-00989-w

More information

Latest update

3/19/2018