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揭示亚临床动脉粥样硬化:颈动脉超声对类风湿关节炎患者评估的影响。

Unmasking Subclinical Atherosclerosis: The Impact of Carotid Ultrasound on the Evaluation of Patients With Rheumatoid Arthritis.

作者信息

Moreno Ramiro A, Ayala Ugarte Cesar, Hernández Emmanuel Amaro, Sánchez Olivan Eric, Leal Villanueva Daniel I, Flores Serrano Fabiola, Rojas de León Diana Laura, Zaragoza Pérez Azul F, Reyes Loaiza Angie Pamela, Velázquez Domínguez Fernanda J, Ibarra Hernández Cesar E, Flores Reséndiz María de la Luz, Castillo Jaqueline L, Flores Valdés Jose R

机构信息

Cardiology, Autonomous University of Nuevo León, Monterrey, MEX.

Cardiology, Autonomous University of Guadalajara, Guadalajara, MEX.

出版信息

Cureus. 2025 Mar 13;17(3):e80525. doi: 10.7759/cureus.80525. eCollection 2025 Mar.

Abstract

Rheumatoid arthritis (RA) is the most prevalent autoimmune disease, characterized by chronic joint inflammation and systemic symptoms, particularly affecting cardiovascular health through atherosclerosis development. This study investigates the role of carotid ultrasound in detecting atherosclerosis in RA patients by measuring carotid intima-media thickness (CIMT). We conducted a comprehensive review of studies published from 2017 to 2024, sourced from PubMed, focusing specifically on CIMT measurements in RA patients. Our analysis included eight studies involving a total of 1,242 participants. The results demonstrate that increased CIMT measurements in RA patients are associated with a higher risk of subclinical atherosclerosis. Notably, most studies (N = 7) reported statistically significant increases in CIMT, while only one study found no significant difference. These findings suggest that CIMT is a valuable tool for assessing cardiovascular risk in RA patients, advocating for the more frequent use of carotid ultrasound as a noninvasive clinical assessment method for this population. However, further multicentric randomized controlled trials and enhanced training for healthcare providers are necessary to ensure accurate CIMT measurements in routine practice.

摘要

类风湿性关节炎(RA)是最常见的自身免疫性疾病,其特征为慢性关节炎症和全身症状,尤其通过动脉粥样硬化的发展影响心血管健康。本研究通过测量颈动脉内膜中层厚度(CIMT)来调查颈动脉超声在检测RA患者动脉粥样硬化中的作用。我们对2017年至2024年发表的研究进行了全面回顾,这些研究来自PubMed,特别关注RA患者的CIMT测量。我们的分析包括八项研究,共涉及1242名参与者。结果表明,RA患者CIMT测量值增加与亚临床动脉粥样硬化风险较高相关。值得注意的是,大多数研究(N = 7)报告CIMT有统计学显著增加,而只有一项研究未发现显著差异。这些发现表明,CIMT是评估RA患者心血管风险的有价值工具,提倡更频繁地使用颈动脉超声作为该人群的非侵入性临床评估方法。然而,需要进一步的多中心随机对照试验和对医疗保健提供者进行强化培训,以确保在常规实践中准确测量CIMT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6146/11993276/edaa1bdbd12e/cureus-0017-00000080525-i01.jpg

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