Rheumatology Division, Hospital Universitario Doctor Peset, Valencia, Spain.
Internal Medicine Division, Hospital de Sagunto, Valencia, Spain.
Clin Rheumatol. 2017 Nov;36(11):2601-2606. doi: 10.1007/s10067-017-3680-z. Epub 2017 May 25.
Arterial stiffness can enhance cardiovascular risk by increasing atherogenesis or adverse hemodynamic effects. We examined whether the arterial stiffness markers of aortic pulse wave velocity (PWV) and the augmentation index (AIx) are independently associated with carotid artery intima-media thickness (IMT) and plaque in patients with rheumatoid arthritis (RA). PWV and AIx were determined by brachial oscillometry using the Mobil-O-Graph® system and carotid IMT and plaque by ultrasound in 194 consecutive RA patients without established cardiovascular disease, chronic kidney disease, and diabetes at disease onset. In crude analysis, PWV was associated with IMT (β (95% CI) = 0.04 (0.03 to 0.05), p value < 0.0001) and plaque (OR (95% CI) = 1.69 (1.40 to 2.04), p value < 0.0001). Upon adjustment for the confounders of age, sex, mean blood pressure, body height, and cardiovascular risk factors comprising smoking, the atherogenic index, and diabetes, PWV was not related to IMT (β (95% CI) = 0.01 (-0.02 to 0.04), p value = 0.5) or plaque (OR (95% CI) = 0.99 (0.96 to 1.01), p value = 0.3). AIx was not associated with IMT in crude (β (95% CI) = -0.002 (-0.004 to 0.007), p value = 0.2) and adjusted analyses (β (95% CI) = -0.002 (-0.004 to 0.000), p value = 0.06). AIx was also unrelated to carotid plaque in crude (OR (95% CI) = 1.04 (0.60 to 1.82), p value = 0.9) and adjusted analyses (OR (95% CI) = 0.97 (0.94 to 1.01), p value = 0.1). PWV and AIx are not independently associated with subclinical carotid atherosclerosis in RA.
动脉僵硬度可通过增加动脉粥样硬化形成或不良血流动力学效应来增加心血管风险。我们研究了主动脉脉搏波速度 (PWV) 和增强指数 (AIx) 等动脉僵硬度标志物是否与类风湿关节炎 (RA) 患者的颈动脉内膜中层厚度 (IMT) 和斑块独立相关。通过 Mobil-O-Graph®系统的臂动脉振荡测量法确定 PWV 和 AIx，通过超声确定颈动脉 IMT 和斑块，共纳入 194 例无心血管疾病、慢性肾脏病和糖尿病的连续 RA 患者。在粗分析中，PWV 与 IMT 相关（β（95%可信区间）= 0.04（0.03 至 0.05），p 值 < 0.0001）和斑块（比值比（95%可信区间）= 1.69（1.40 至 2.04），p 值 < 0.0001）。在调整年龄、性别、平均血压、身高和包括吸烟、致动脉粥样硬化指数和糖尿病在内的心血管危险因素后，PWV 与 IMT 无关（β（95%可信区间）= 0.01（-0.02 至 0.04），p 值 = 0.5）或斑块（比值比（95%可信区间）= 0.99（0.96 至 1.01），p 值 = 0.3）。AIx 在粗分析中与 IMT 无关（β（95%可信区间）=-0.002（-0.004 至 0.007），p 值 = 0.2）和调整分析中也无关（β（95%可信区间）=-0.002（-0.004 至 0.000），p 值 = 0.06）。AIx 在粗分析中与颈动脉斑块也无关（比值比（95%可信区间）= 1.04（0.60 至 1.82），p 值 = 0.9）和调整分析中也无关（比值比（95%可信区间）= 0.97（0.94 至 1.01），p 值 = 0.1）。在 RA 中，PWV 和 AIx 与亚临床颈动脉粥样硬化无独立相关性。
