Incidence of new carotid plaques in rheumatoid arthritis patients: 6-Year prospective results of the TOMORROW study

Mod Rheumatol. 2023 Apr 13;33(3):481-489. doi: 10.1093/mr/roac051.

Abstract

Objectives: The purpose of this study was to evaluate the new incidence of carotid plaques in rheumatoid arthritis (RA) patients over a 6-year prospective follow-up and to assess the risk factors.

Methods: This is a 10-year prospective cohort study that included 208 RA patients and 205 age- and gender-matched controls. Ultrasound assessment of the bilateral carotid arteries was performed in 2011 and 2017.

Results: There were no differences in the incidence of new carotid atherosclerotic plaques over 6 years between the two groups (35.5% vs. 37.0%, respectively; p = .936). The mean Disease Activity Score 28-C-reactive protein over 6 years in RA patients was 2.73 ± 0.95. Multiple logistic regression analysis showed that RA was not a risk factor for new carotid atherosclerotic plaques (odds ratios, 0.708; 95% confidence interval, 0.348-1.440; p = .340). An average glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques (odds ratios, 8.54; 95% confidence interval, 1.641-44.455; p = .011).

Conclusions: Incidence of new carotid atherosclerotic plaques was similar between well-controlled disease activity RA patients and control subjects. A mean glucocorticoid dose of >1.8 mg/day over 6 years was a risk factor for new carotid atherosclerotic plaques.

Keywords: Rheumatoid arthritis; carotid ultrasound; glucocorticoid; new carotid plaques; plaque score.

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnostic imaging
  • Arthritis, Rheumatoid* / epidemiology
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Diseases* / complications
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / epidemiology
  • Glucocorticoids
  • Humans
  • Incidence
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Prospective Studies
  • Risk Factors

Substances

  • Glucocorticoids