Early RA Dsease Management May Reduce Risk of Cardiovascular Disease

Inflammation early in the rheumatoid arthritis (RA) disease course is associated with 2 measures of arterial stiffness, increased pulse-wave velocity (PWV) and augmentation index (AIx), after 15 years. Early, active disease management to control inflammation in patients with RA may help reduce the risk of later cardiovascular (CV) disease.

Provan and associates followed 238 patients with early RA longitudinally; 108 were available for the 15-year follow-up examination. Comprehensive baseline clinical (eg, C-reactive protein [CRP] level) and radiographic data were collected, and AIx and PWV were recorded at the 15-year follow-up. The association between baseline variables and later increased AIx and PWV were examined in parallel logistic regression procedures, with adjustments for age, sex, and mean arterial pressure.

Elevated baseline CRP level predicted increased AIx and PWV at 15 years in univariate and multivariate models. Current CRP level increased the odds ratio for increased PWV for patients with an elevated baseline CRP level, without contributing independently to the model. Female sex was a significant positive effect modifier of elevated baseline CRP level in the prediction of increased PWV.

The authors noted that the PWV is an established independent predictor of all-cause and CV mortality in populations with and those without pathological conditions.