Cerebrovascular risk in rheumatoid arthritis patients: insights from carotid artery atherosclerosis in the Paracelsus 10,000 study

作者：Mathias Ausserwinkler, Sophie Gensluckner, Vanessa Frey, Isabella Gostner, Bernhard Paulweber, Eugen Trinka, Patrick B. Langthaler, Christian Datz, Bernhard Iglseder, Jens Thiel, H Neumann, Maria Flamm, Elmar Aigner, Bernhard Wernly · 发表于：Rheumatology International · 年份：2025 · DOI：10.1007/s00296-024-05781-4 · 被引用次数：19 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Systemic Lupus Erythematosus Research、Acute Ischemic Stroke Management

Abstract Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation. While RA primarily affects the joints, its systemic effects may lead to an increased cerebro- and cardiovascular risk. Atherosclerosis of the carotid arteries is a significant risk factor for cerebrovascular events and serves as a surrogate marker for cardiovascular risk. This study explores the link between RA and carotid artery atherosclerosis with data from the Paracelsus 10,000 Study. Baseline assessments were conducted on individuals randomly selected from Salzburg and its surrounding regions. Participants diagnosed with RA based on ACR-EULAR classification criteria and who underwent carotid artery ultrasound were included. Data were gathered from a total of 9729 participants, among whom 299 were diagnosed with RA. Carotid arteries were examined using ultrasound imaging. The primary endpoint was the difference in the prevalence of plaque presence between the RA and non-RA groups. One univariate (Model I) and three multivariate analyses were conducted, with adjustments in Model II incorporating SCORE 2, while Model III accounted for metabolic syndrome, age and sex. Additionally, Model IV included further adjustments for high-sensitivity C-reactive protein (hs-CRP). Plaque presence was defined as the ultrasound detection of plaque formation larger than 0 mm 2 , regardless of whether it was unilateral or bilateral. Additional assessments included carotid stenosis, intima-medi...