Rheumatoid arthritisCarotid Intima Media Thickness in Rheumatoid Arthritis as Compared to Control Subjects: A Meta-Analysis
Section snippets
Search and Review Strategy
A systematic search of the literature published between January 1966 and December 2008 was conducted in MEDLINE and EMBASE to identify all articles using cIMT as a surrogate measure of CV risk in RA patients compared with control subjects. Search terms were used in every possible spelling, as synonyms, acronyms, key- or text words, and these groups were combined with an āANDā operator. The following key words were used in all fields: āarthritis, rheumatoidā AND ācarotid atherosclerosisā OR
Results
The search resulted in 53 potential articles of interest, of which 22 were included (Fig. 1). In all studies, RA patients were recruited from hospital-outpatient clinics and fulfilled the American College of Rheumatology criteria (20). Table 1 summarizes the clinical characteristics and the degree of comparability with regard to other CV risk factors of each study. Only 4 of 22 studies (17%) included 100 or more RA patients and most studies investigated middle-aged female RA patients. Overall,
Discussion
The key finding of this meta-analysis is a statistically significantly greater cIMT in RA patients compared with control subjects, supporting epidemiological evidence for an increased CV burden in these patients. In fact, of all 22 studies identified, only 1 study reported a smaller cIMT in RA patients. In this particular study, RA patients were compared with controls obtained from a hypertension cohort (29). In accordance with this, we observed that the cIMT difference was significantly higher
References (50)
- et al.
Rheumatoid arthritis: a disease associated with accelerated atherogenesis
Semin Arthritis Rheum
(2005) - et al.
Pravastatin, lipids, and atherosclerosis in the carotid arteries (PLAC-II)
Am J Cardiol
(1995) - et al.
Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis
J Clin Epidemiol
(2001) - et al.
Apolipoprotein A-I-dependent cholesterol esterification in patients with rheumatoid arthritis
Life Sci
(2005) - et al.
Auto-antibodies do not influence development of atherosclerotic plaques in rheumatoid arthritis
Joint Bone Spine
(2008) - et al.
Augmentation index and large-artery remodeling in patients with longstanding rheumatoid arthritis compared with healthy controls
Semin Arthritis Rheum
(2009) - et al.
Impaired coronary microvascular function and increased intima-media thickness in rheumatoid arthritis
Atherosclerosis
(2008) - et al.
Early treatment reduces the cardiovascular risk factors in newly diagnosed rheumatoid arthritis patients
Semin Arthritis Rheum
(2008) - et al.
Carotid intima-media thickness predicts the development of cardiovascular events in patients with rheumatoid arthritis
Semin Arthritis Rheum
(2009) - et al.
Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States
Arthritis Rheum
(1998)
Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis?
Arthritis Rheum
Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies
Arthritis Rheum
Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis
Circulation
High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors
Arthritis Rheum
Explaining how āhigh-gradeā systemic inflammation accelerates vascular risk in rheumatoid arthritis
Circulation
The pathogenesis of atherosclerosis: a perspective for the 1990s
Nature
Mannheim carotid intima-media thickness consensus (2004-2006)An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006
Cerebrovasc Dis
Ultrasound imaging techniques for the evaluation of cardiovascular therapies
Eur Heart J
Effect of lovastatin on early carotid atherosclerosis and cardiovascular events
Circulation
Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study
Circulation
Measuring inconsistency in meta-analyses
BMJ
Quantifying heterogeneity in a meta-analysis
Stat Med
Bias in meta-analysis detected by a simple, graphical test
BMJ
Controlling the risk of spurious findings from meta-regression
Stat Med
How should meta-regression analyses be undertaken and interpreted?
Stat Med
Cited by (0)
Disclosures: Professor Dijkmans received educational grants from Wyeth, Abbot, and Pfizer. The other authors have no conflicts of interest to disclose.
- 1
These authors contributed equally on this article.