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Giovagnoni A, De Filippo M, Barile A. Diagnostic and interventional radiology: an update. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:5-8. [PMID: 32945273 PMCID: PMC7944668 DOI: 10.23750/abm.v91i8-s.9995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
NOT PRESENT.
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Affiliation(s)
- Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, AN, Italy.
| | - Massimo De Filippo
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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2
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Carotti M, Salaffi F, Filippucci E, Aringhieri G, Bruno F, Giovine S, Gentili F, Floridi C, Borgheresi A, De Filippo M, Masciocchi C, Barile A, Giovagnoni A. Clinical utility of Dual Energy Computed Tomography in gout: current concepts and applications. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:116-124. [PMID: 32945286 PMCID: PMC7944678 DOI: 10.23750/abm.v91i8-s.9942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 12/17/2022]
Abstract
Gout is the most common inflammatory arthritis and is increasing in prevalence and incidence in many countries worldwide. Dual Energy Computed Tomography (DECT) has a high diagnostic accuracy in established gout, but its diagnostic sensitivity is low in subjects with recent-onset gout. A meta-analysis of 17 studies showed a pooled sensitivity and specificity of 0.85 and 0.88, respectively. DECT is a useful diagnostic tool for patients with contraindications for joint aspiration or for those who refuse joint aspiration. This article aims to give an up to date review and summary of existing literature on the role and accuracy of DECT in the imaging of gout. (www.actabiomedica.it)
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Affiliation(s)
- Marina Carotti
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Lancisi -Salesi"- Universiy Politecnica Marche - Via Conca 71, 60126 Ancona, AN, Italy. .
| | - Fausto Salaffi
- Rheumatological Clinic, Department of Molecular and Clinical Sciences, University Politecnica Marche - Ancona, Italy.
| | - Emilio Filippucci
- Rheumatological Clinic, Department of Molecular and Clinical Sciences, University Politecnica Marche - Ancona, Italy.
| | - Giacomo Aringhieri
- Radiologia Diagnostica ed Interventistica, Dipartimento di ricercar Traslazionale e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy.
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
| | - Sabrina Giovine
- Department of Radiology, SG Moscati Hospital, ASL Caserta, Aversa, Caserta, Italy.
| | - Francesco Gentili
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy.
| | - Chiara Floridi
- University Politecnica delle Marche, Department of Clinical Special and Dental Sciences, Ancona, Italy.
| | - Alessandra Borgheresi
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Lancisi -Salesi"- University Politecnica Marche - Ancona, Italy.
| | - Massimo De Filippo
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Giovagnoni
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Lancisi -Salesi"- University Politecnica Marche - Ancona, Italy.
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3
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Bruno F, Palumbo P, Arrigoni F, Mariani S, Aringhieri G, Carotti M, Natella R, Zappia M, Cipriani P, Giacomelli R, Di Cesare E, Splendiani A, Masciocchi C, Barile A. Advanced diagnostic imaging and intervention in tendon diseases. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:98-106. [PMID: 32945284 PMCID: PMC7944667 DOI: 10.23750/abm.v91i8-s.10007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022]
Abstract
Degenerative tendon pathology represents one of the most frequent and disabling musculoskeletal disorders. Diagnostic radiology plays a fundamental role in the clinical evaluation of tendon pathologies. Moreover, several minimally invasive treatments can be performed under imaging guidance to treat tendon disorders, maximizing the efficacy and reducing procedural complications. In this review article we describe the most relevant diagnostic features of conventional and advanced US and MRI imaging in tendon disorders, along with the main options for image-guided intervention. (www.actabiomedica.it)
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Affiliation(s)
- Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Silvia Mariani
- Emergency Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Marina Carotti
- Dipartimento di Scienze Radiologiche S. O. D. Radiologia Pediatrica e Specialistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti "Umberto I-G.M. Lancisi-Salesi", and Dipartimento di Scienze Cliniche Specialistiche e Odontostomatologiche, University Politecnica delle Marche, Ancona, Italy.
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Paola Cipriani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Roberto Giacomelli
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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4
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Acanfora C, Bruno F, Palumbo P, Arrigoni F, Natella R, Mazzei MA, Carotti M, Ruscitti P, Di Cesare E, Splendiani A, Giacomelli R, Masciocchi C, Barile A. Diagnostic and interventional radiology fundamentals of synovial pathology. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:107-115. [PMID: 32945285 PMCID: PMC7944671 DOI: 10.23750/abm.v91i8-s.9993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 01/15/2023]
Abstract
The synovial membrane is a specialized mesenchymal tissue that lines the diarthrodial joints surfaces, bursae, and tendon sheaths of the body. This article aims to provide an overview of the fundamentals of synovial tissue, with particular regard to the imaging findings of the main pathologic processes that can affect the synovia and the role of image-guided interventions. (www.actabiomedica.it)
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Affiliation(s)
- Chiara Acanfora
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Marina Carotti
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Lancisi - Salesi", Ancona, Italy.
| | - Piero Ruscitti
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Roberto Giacomelli
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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Zhang DY, Cheng YB, Guo QH, Wang Y, Sheng CS, Huang QF, An DW, Li MX, Huang JF, Xu TY, Wang JG, Li Y. Subtypes of masked hypertension and target organ damage in untreated outpatients. Blood Press 2020; 29:299-307. [PMID: 32400191 DOI: 10.1080/08037051.2020.1763159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Dong-Yan Zhang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi-Bang Cheng
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qian-Hui Guo
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Wang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chang-Sheng Sheng
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi-Fang Huang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - De-Wei An
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ming-Xuan Li
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian-Feng Huang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ting-Yan Xu
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Li
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Abrahão-Machado ECF, Mendonça JA, Arruda ACBB, Nucci LB, Santos MASD. Analysis of cardiovascular risk and carotid intima-media thickness in patients with psoriasis. An Bras Dermatol 2020; 95:150-157. [PMID: 32122693 PMCID: PMC7175101 DOI: 10.1016/j.abd.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/11/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Psoriasis is associated with atherosclerosis and increased cardiovascular risk. Currently, an automated ultrasound, called quantitative intima media thickness, has proven to be a useful method to evaluate subclinical atherosclerosis. OBJECTIVES To compare increased cardiovascular risk in psoriasis patients receiving two types of treatments: Methotrexate and tumor necrosis factor inhibitor and to evaluate the correlation between the Framingham score and quantitative intima media thickness. METHODS Fifty patients with plaque psoriasis were selected from June 2017 to July 2018, divided into two groups, receiving methotrexate and tumor necrosis factor inhibitor. Measurement of abdominal circumference, blood pressure, body mass index and presence of metabolic syndrome were performed. Afterwards, the patients were evaluated for increased cardiovascular risk with the Framingham score and for the quantitative intima media thickness of the carotid arteries. RESULTS The mean age was 54.8 (±12.5) with a slight male predominance (58%). Overall, 84% of the patients had elevated waist circumference, 82% had a body mass index above ideal, and 50% had a metabolic syndrome. For the correlation between quantitative intima media thickness and Framingham Score, Pearson's linear correlation coefficient was 0.617 (p<0.001), indicating a moderate to strong positive association. STUDY LIMITATIONS The protective effect of the therapies cited in relation to the increased cardiovascular risk was not evaluated. CONCLUSIONS A moderate to strong positive association was found correlating the Framingham Score values with the quantitative intima media thickness measurement and it is not possible to state which drug has the highest increased cardiovascular risk.
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Affiliation(s)
| | - José Alexandre Mendonça
- Rheumatology Outpatient Clinic, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
| | | | - Luciana Bertoldi Nucci
- Postgraduate Program, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
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Mendonça JA, de Andrade BB, de Aquino JLB, Leandro-Merhi VA, Damian GB. Spectral Doppler and automated software-guided ultrasound assessment of bilateral common carotid intima-media thickness in spondyloarthritis: is there a correlation with clinical findings? Drugs Context 2018; 7:212538. [PMID: 30214463 PMCID: PMC6132676 DOI: 10.7573/dic.212538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 01/25/2023] Open
Abstract
Background and aim Limited information is currently available about whether carotid intima-media thickness (IMT) correlates with the degree of disease activity in spondyloarthritis. The objective of this study was to evaluate the correlation between articular and carotid ultrasound data and laboratory and clinical variables in patients with spondyloarthritis. Methods Twenty-two patients with spondyloarthritis, recruited consecutively via the spondyloarthritis service of the Universidade Pontifícia Católica de Campinas, São Paulo, Brazil, were assessed using carotid artery ultrasound (radiofrequency quality intima-media thickness, RF-QIMT), joint ultrasound, clinical evaluation, and laboratory tests. Results Mean (standard deviation, SD) carotid RF-QIMT was 0.643 (0.16) mm. Mean (SD) resistive index (RI) values for the right and left carotid arteries were 0.67 (0.12) and 0.82 (0.38), respectively. Mean (SD) RI values for the right and left sacroiliac joints were 1.10 (0.97) and 0.94 (0.13), respectively. Several significant correlations were detected between ultrasound, clinical, and laboratory variables. Notably, there were correlations between sacroiliac RI and erythrocyte sedimentation rate (p=0.027) and RF-QIMT (p=0.037); between RF-QIMT and Framingham score (p=0.012) and metabolic parameters, including abdominal waist measurement, body mass index (BMI) (p=0.032 to p=0.044). Conclusions In patients with spondyloarthritis, RF-QIMT detected atherosclerotic changes in the carotid artery wall, and spectral Doppler detected inflammatory activity in sacroiliac joints. Positive correlations were observed between these ultrasound findings and parameters reflecting patients’ metabolic profile and alterations in inflammatory markers.
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Affiliation(s)
- José Alexandre Mendonça
- Serviço de Reumatologia e Pós Graduação da Universidade Pontifícia Católica de Campinas, São Paulo, Brazil.,Graduate Program in Health Sciences, PUC-Campinas - SP-Brazil Research Group: Diagnostics and Clinical and Surgical Therapy, São Paulo, Brazil
| | - Beatriz Bisetto de Andrade
- Serviço de Reumatologia e Pós Graduação da Universidade Pontifícia Católica de Campinas, São Paulo, Brazil.,Graduate Program in Health Sciences, PUC-Campinas - SP-Brazil Research Group: Diagnostics and Clinical and Surgical Therapy, São Paulo, Brazil
| | - José Luis Braga de Aquino
- Graduate Program in Health Sciences, PUC-Campinas - SP-Brazil Research Group: Diagnostics and Clinical and Surgical Therapy, São Paulo, Brazil.,Serviço de Clínica Cirúrgica e Pós Graduação da Universidade Pontifícia Católica de Campinas, São Paulo, Brazil
| | - Vania Aparecida Leandro-Merhi
- Graduate Program in Health Sciences, PUC-Campinas - SP-Brazil Research Group: Diagnostics and Clinical and Surgical Therapy, São Paulo, Brazil.,Serviço de Nutrição e Pós Graduação da Universidade Pontifícia Católica de Campinas, São Paulo, Brazil
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Zardi EM, Giorgi C, Zardi DM. Diagnostic approach to neuropsychiatric lupus erythematosus: what should we do? Postgrad Med 2018; 130:536-547. [PMID: 29940795 DOI: 10.1080/00325481.2018.1492309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Neuropsychiatric systemic lupus erythematosus is a diagnostic challenge due to the multifarious neurological and psychiatric manifestations that define it but, when suspected, diagnostic imaging can give a fundamental help. The advancements and variety of neuroimaging techniques allow us to perform more and more accurate evaluations of structure, perfusion, and metabolism of the brain and to detect cerebral and spinal lesions. Moreover, vascular districts of the neck and the brain, as well as the electrical brain and peripheral muscle activity may be accurately investigated, thus giving us a wide panoramic view. Although magnetic resonance is recognized as a fundamental neuroimaging technique to reach a correct diagnosis, the juxtaposition of other diagnostic techniques has improved the possibility to make diagnoses but has also increased the confusion about deciding which of them to use and when. Our aim was to combine the number of available techniques with the need to simplify the diagnostic path. Therefore, through the construction of an algorithm from an evidence based approach, we believe we are providing some added improvements to facilitate and expedite the diagnosis of NPSLE.
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Affiliation(s)
| | - Chiara Giorgi
- b Radiology Department , S Maria della Misericordia Hospital , Urbino , Italy
| | - Domenico Maria Zardi
- c Division of Cardiology, Faculty of Medicine and Psychology , University of Rome "Sapienza", Sant'Andrea Hospital , Rome , Italy
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Zardi EM, Pipita ME, Giorgi C, Lichinchi D, Zardi DM, Afeltra A. Differences in carotid atherosclerosis between patients with ankylosing spondylitis treated with tumor necrosis factor-α antagonists and healthy matched controls. Medicine (Baltimore) 2018; 97:e11250. [PMID: 29979389 PMCID: PMC6076036 DOI: 10.1097/md.0000000000011250] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
An increased vascular risk is present in patients with ankylosing spondylitis (AS). In this report, we evaluate the presence and grade of atherosclerosis in patients with AS, uninterruptedly treated with tumor necrosis factor-α (TNF-α) antagonists for 2 years, in comparison to that in a nontreated group of healthy controls.Fourteen patients with AS and 14 healthy controls underwent carotid sonography to measure intima-media thickness (IMT) and to evaluate the presence of plaque. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index scores, erythrocyte sedimentation rate, C-reactive protein, glycemia, total cholesterol, and triglyceride levels were also recorded.Patients with AS showed significantly lower values of mean and maximum IMT at the level of the common carotid (P = .02 and .04, respectively) and the carotid bulb (P = .0006 and .0005, respectively) compared to those of healthy controls. They also had a number of carotid plaques significantly lower than that of healthy controls (P = .02). No differences were found in IMT values at the level of internal carotid between the 2 populations.The significantly lower carotid atherosclerosis found in patients with AS treated with TNF antagonists than in healthy controls shows the important complementary role of this treatment in reducing vascular disease progression probably by decreasing inflammation.
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Affiliation(s)
| | | | - Chiara Giorgi
- Radiology Department, S Maria della Misericordia Hospital, Urbino
| | | | - Domenico Maria Zardi
- Division of Cardiology, Faculty of Medicine and Psychology, University of Rome “Sapienza,” Sant’Andrea Hospital
| | - Antonella Afeltra
- Immunorheumatology Unit, “Campus Bio-Medico” University, Rome, Italy
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Martinez-Lopez A, Blasco-Morente G, Perez-Lopez I, Tercedor-Sanchez J, Arias-Santiago S. Studying the effect of systemic and biological drugs on intima-media thickness in patients suffering from moderate and severe psoriasis. J Eur Acad Dermatol Venereol 2018; 32:1492-1498. [PMID: 29405437 DOI: 10.1111/jdv.14841] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psoriasis has been related to a large number of cardiovascular risk factors such as hypertension, diabetes mellitus and arteriosclerosis. The increased carotid intima-media thickness (IMT) could be considered to be a marker of generalized arteriosclerosis. OBJECTIVE To assess the effect of systemic and biological drugs on psoriatic patients' carotid IMT. METHODS A prospective study was performed. We studied 53 patients with moderate and severe psoriasis from our psoriasis dermatological unit, analysing lipid and glucose metabolism and performing a carotid IMT sonography before introduction of systemic and biological drugs. After that, we performed an 8-month closely analytic and sonographic follow-up. RESULTS The IMT of the patients with psoriasis treated with biological drugs tended to decrease, although this occurrence was not statistically significant (P = 0.086). The subgroup analysis revealed that patients treated with methotrexate (P = 0.045) and anti-IL-12/23 (P = 0.010) presented a decrease in their IMT levels. This analysis also showed a decrease in glycaemia and insulin levels in patients treated with TNF-alpha inhibitors and ustekinumab. CONCLUSIONS Our study suggests that the carotid IMT may benefit from treatment with biological drugs, particularly anti-IL-12/23 and methotrexate in patients suffering from moderate and severe psoriasis. However, larger longitudinal studies should be performed to fully confirm these results.
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Affiliation(s)
- A Martinez-Lopez
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - G Blasco-Morente
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - J Tercedor-Sanchez
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - S Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Medicine College, University of Granada, Granada, Spain
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11
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Franzago M, Fraticelli F, Di Nicola M, Bianco F, Marchetti D, Celentano C, Liberati M, De Caterina R, Stuppia L, Vitacolonna E. Early Subclinical Atherosclerosis in Gestational Diabetes: The Predictive Role of Routine Biomarkers and Nutrigenetic Variants. J Diabetes Res 2018; 2018:9242579. [PMID: 30671483 PMCID: PMC6323479 DOI: 10.1155/2018/9242579] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/17/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022] Open
Abstract
Gestational diabetes mellitus (GDM) can be considered a silent risk for out-of-pregnancy diabetes mellitus (DM) and cardiovascular disease (CVD) later in life. We aimed to assess the predictive role of 3rd trimester lipid profile during pregnancy for the susceptibility to markers of subclinical atherosclerosis (CVD susceptibility) at 3 years in a cohort of women with history of GDM. A secondary aim is to evaluate the usefulness of novel nutrigenetic markers, in addition to traditional parameters, for predicting early subclinical atherosclerosis in such women in order to plan adequate early prevention interventions. We assessed 28 consecutive GDM women in whom we collected socio-demographic characteristics and clinical and anthropometric parameters at the 3rd trimester of pregnancy. In a single blood sample, from each patient, we assessed 9 single nucleotide polymorphisms (SNPs) from 9 genes related to nutrients and metabolism, which were genotyped by High Resolution Melting analysis. All women then attended a 3-year-postpartum follow-up and on that occasion performed an oral glucose tolerance test (OGTT, with 75 g oral glucose), the measurement of carotid artery intima-media thickness (cIMT), and analyses of metabolic parameters. In addition, we evaluated the physical activity level and the adherence to Mediterranean diet (MedDiet) using the International Physical Activity Questionnaire (IPAQ-short version) and PREDIMED questionnaires. We found an association between 3rd trimester triglycerides and cIMT (p = 0.014). We also found significant associations between the APOA5 CC genotype and cIMT after adjustments for age and body mass index (p = 0.045) and between the interaction CC APOA5/CC LDLR and cIMT (p = 0.010). At the follow-up, the cohort also featured a mean BMI in the overweight range and a high mean waist circumference. We found no difference in the MedDiet adherence, physical activity, and smoking but an inverse correlation between the PREDIMED and the IPAQ scores with the IMT. In conclusion, this preliminary study provides insight into the predictive role of lipid profile during pregnancy and of some genetic variants on cIMT taken as a parameter of subclinical CVD susceptibility in GDM.
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Affiliation(s)
- Marica Franzago
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Federica Fraticelli
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Francesco Bianco
- Institute of Cardiology, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Claudio Celentano
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Marco Liberati
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Raffaele De Caterina
- Institute of Cardiology, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Liborio Stuppia
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio” University, Chieti-Pescara, Chieti, Italy
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Zardi EM, Di Geso L, Afeltra A, Zardi DM, Giorgi C, Salaffi F, Carotti M, Gutierrez M, Filippucci E, Grassi W. An ultrasound automated method for non-invasive assessment of carotid artery pulse wave velocity. J Investig Med 2017; 66:973-979. [PMID: 28866633 DOI: 10.1136/jim-2017-000430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 12/29/2022]
Abstract
To validate the clinical applicability and feasibility of an automated ultrasound (US) method in measuring the arterial stiffness of patients with chronic inflammatory rheumatic diseases, comparing automated measurements performed by a rheumatologist without experience in vascular sonography with those obtained by a sonographer experienced in vascular US, using a standardized manual method. Twenty subjects affected by different chronic inflammatory rheumatic disorders were consecutively recruited. For each patient, the arterial stiffness of both common carotids was manually calculated. Subsequently, the measure of the pulse wave velocity (PWV) was obtained using an US device called Radio Frequency - Quality Arterial Stiffness (RF-QAS), provided by the same US system (ie, My Lab 70 XVG, Esaote SpA, Genoa, Italy) equipped with a 4-13 MHz linear probe. The reliability comparison between the two US methods was calculated using the intraclass correlation coefficient (ICC). ICC between the values obtained with the two methods for calculating the arterial stiffness resulted 0.789. A significant positive correlation between the two methods was also established with Pearson's (r=0.62, p<0.0001) and Spearman's analysis (r=0.66, p=0.001). A significant performance comparison was seen using Bland-Altman plot. The acquisition of the arterial stiffness parameter with the automated method required about 2 min for each patient. Clinical applicability of this US automated method to assess PWV at common carotid level by a rheumatologist is reliable and feasible in comparison with a conventional manual method.
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Affiliation(s)
- Enrico Maria Zardi
- Department of Immunorheumatology, Università "Campus Bio-Medico", Roma, Italy
| | - Luca Di Geso
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Antonella Afeltra
- Department of Immunorheumatology, Università "Campus Bio-Medico", Roma, Italy
| | - Domenico Maria Zardi
- Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza", Sant'Andrea Hospital, Rome, Italy
| | - Chiara Giorgi
- Department of Radiology, S. Maria della Misericordia Hospital, Urbino, Italy
| | - Fausto Salaffi
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Marina Carotti
- Istituto di Radiologia, Università Politecnica delle Marche, Ancona, Italy
| | - Marwin Gutierrez
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Emilio Filippucci
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
| | - Walter Grassi
- Department of Rheumatology, Polytechnic University of the Marche, Jesi - Ancona, Italy
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Carotid Intima-Media Thickness Manual Measurements: Intraoperator and Interoperator Agreements Under A Strict Protocol in a Large Sample. Ultrasound Q 2016; 33:28-36. [PMID: 27575841 DOI: 10.1097/ruq.0000000000000243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to assess the intraoperator and interoperator agreement for manual measurements of intima-media thickness (IMT) performed under a strict carotid ultrasound technical protocol. METHODS Two blinded experienced operators independently performed an ultrasound examination at the distal common carotid of 242 subjects in the same patient's position, diastolic phase, probe type, zooming, and depth. Thirty-six subjects were reevaluated in another time point. Three different-angle manual measurements (IMTindiv) were obtained. Interoperator agreements for each IMTindiv, and their mean (IMTmean) and maximum (IMTmax) values, were assessed with the intraclass correlation coefficient and Bland-Altman analysis. Intraoperator agreement was tested taking advantage of the second ultrasound round in 36 subjects. RESULTS IMTmean agreements (intraoperator, 0.665-0.913; interoperator, 0.856-0.897) were higher than IMTmax (intraoperator, 0.435-0.793; interoperator, 0.631-0.718) and any IMTindiv (intraoperator, 0.355-0.676; interoperator, 0.590-0.717). Despite the small systematic error for IMTmean (intraoperator, ≤0.03; interoperator, ≤0.02 mm), at best of times, the sampling error size reached at least 0.28 and 0.25 mm for intraoperator and interoperator agreements, respectively, and was never less than 0.13 mm. CONCLUSIONS Although IMTmean agreement is excellent under a strict protocol, limits of agreement might be too wide to consider carotid ultrasound a robust cardiovascular risk biomarker.
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Gaibazzi N, Rigo F, Facchetti R, Carerj S, Giannattasio C, Moreo A, Mureddu GF, Salvetti M, Grolla E, Faden G, Cesana F, Faggiano P. Differential incremental value of ultrasound carotid intima-media thickness, carotid plaque, and cardiac calcium to predict angiographic coronary artery disease across Framingham risk score strata in the APRES multicentre study. Eur Heart J Cardiovasc Imaging 2015; 17:991-1000. [PMID: 26358694 DOI: 10.1093/ehjci/jev222] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/10/2015] [Indexed: 12/15/2022] Open
Abstract
AIMS According to recent data, more accurate selection of patients undergoing coronary angiography for suspected coronary artery disease (CAD) is needed. From the Active PREvention Study multicentre prospective study, we further analyse whether carotid intima-media thickness (cIMT), carotid plaques (cPL), and echocardiographic cardiac calcium score (eCS) have incremental discriminatory and reclassification predictive value for CAD over clinical risk score in subjects undergoing coronary angiography, specifically depending on their low, intermediate, or high class of clinical risk. METHODS AND RESULTS In eight centres, 445 subjects without history of prior CAD but with chest pain of recent onset and/or a positive/inconclusive stress test for ischaemia prospectively underwent clinically indicated elective coronary angiography after cardiac and carotid ultrasound assessments with measurements of cIMT, cPL, and eCS. The study population was divided into subjects at low (10%), intermediate (10-20%), and high (>20%) Framingham risk score (FRS). Ultrasound parameters were tested for their incremental value to predict CAD over FRS, in each pre-test risk category. No significant difference could be appreciated between the discrimination value of FRS and Diagnostic Imaging for Coronary Artery Disease score for the presence of CAD. eCS or cPL demonstrated significant incremental prediction over FRS, consistently in the three FRS categories (P < 0.01); this applied to both discrimination and reclassification, with the exception of high-risk subjects, in whom cPL was apparently not incremental over FRS, and eCS was only of borderline significance for better discrimination. CONCLUSIONS Ultrasound eCS and cPL assessments were significant predictors of angiographic CAD in patients without prior CAD but with signs or symptoms suspect for CAD, independently and incrementally to FRS, across all pre-test risk probability strata, although in high-risk subjects, only eCS maintained an incremental value. The use of cIMT was not significantly incrementally useful in any FRS risk category.
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Affiliation(s)
- Nicola Gaibazzi
- Department of Cardiology, Parma University Hospital, Via Gramsci, 14, Parma 43124, Italy
| | | | - Rita Facchetti
- Niguarda Ca' Granda Hospital and Milano-Bicocca University, Milan, Italy
| | | | | | - Antonella Moreo
- Niguarda Ca' Granda Hospital and Milano-Bicocca University, Milan, Italy
| | | | | | | | | | - Francesca Cesana
- Niguarda Ca' Granda Hospital and Milano-Bicocca University, Milan, Italy
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Cioni G, Berni A, Gensini GF, Abbate R, Boddi M. Impaired Femoral Vascular Compliance and Endothelial Dysfunction in 30 Healthy Male Soccer Players: Competitive Sports and Local Detrimental Effects. Sports Health 2015; 7:335-40. [PMID: 26137179 PMCID: PMC4481678 DOI: 10.1177/1941738115577931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Despite beneficial effects of physical activity on cardiovascular risk, discordant data on elite athletes (high atherosclerotic damage in activity comprising strenuous exertion) and retired sportsmen are reported in the literature. HYPOTHESIS We hypothesize that long-lasting daily physical activity could affect the morphology and function of the carotid and femoral vessel walls differently, as assessed in elite male athletes aged 20 to 30 years compared with age- and sex-matched healthy controls. STUDY DESIGN Retrospective case-control study. LEVEL OF EVIDENCE Level 3. METHODS Sixty male subjects (30 athletes and 30 controls) underwent medical examination for ankle brachial index, augmentation index (AIX) and AIX corrected for heart rate (AIXr), peripheral arterial tonometry (PAT), and intima media thickness and pulse wave velocity assay at common carotid (carotid-intima media thickness [c-IMT], carotid-pulse wave velocity [c-PWv]) and femoral arteries (femoral-intima media thickness [f-IMT], femoral-pulse wave velocity [f-PWv]) assessed by ultrasonography using Doppler ultrasound. RESULTS Athletes showed a significantly lower heart rate (HR) at rest and a better lipid profile than controls. In athletes, c-PWv (5.87 ± 0.80 vs 6.62 ± 1.02 m/s, P = 0.001) and f-PWv (8.96 ± 1.29 vs 7.89 ± 1.39, P = 0.002) were, respectively, significantly lower and higher than values found in controls; accordingly, carotid AIX (4.03 ± 6.21 vs 7.81 ± 5.21, P = 0.003) and femoral AIX (8.56 ± 10.21 vs 6.09 ± 7.95, P = 0.042) were lower and higher than control values, even after correction for heart rate (P = 0.03). On the other hand, IMT values were significantly higher in controls than in athletes (c-IMT, P < 0.0001; f-IMT, P < 0.0001). A positive significant correlation between HR and c-IMT and f-IMT (r = 0.527, P < 0.001 and r = 0.539, P < 0.0001, respectively) and between HR and c-PWv (r = 0.410, P = 0.01) was found when controls and athletes were considered as a whole group. Soccer players showed lower PAT values in comparison with controls (P = 0.002). CONCLUSION Elite sports positively affect c-IMT, f-IMT, and carotid PWv and AIX but not femoral PWv, AIX, AIXr, or PAT. CLINICAL RELEVANCE Physical activity affects vascular beds in elite athletes differentially, depending on the rate of superior or inferior limb involvement in different sports. In soccer players, physical activity has a protective effect on carotid and femoral vessel walls but worsens femoral arterial and endothelial function. These findings highlight how different results can be shown on carotid and femoral districts, when these vascular districts are differently stressed during sport activity.
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Affiliation(s)
- Gabriele Cioni
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Andrea Berni
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Gian Franco Gensini
- Department of Experimental and Clinical Medicine, University of Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Florence, Italy
| | - Rosanna Abbate
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
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Abstract
For decades, diagnostic imaging in rheumatology has used conventional radiography. Over the past 10 years, MRI and ultrasonography have clearly shown their potential in diagnostic imaging in rheumatology and their use is revolutionizing the management of chronic arthritis, revealing subclinical inflammation and predicting progression of joint damage. Although validation processes for these imaging modalities are still ongoing, several investigations have now established the positive correlation between subclinical synovitis and radiographic progression of joint damage. Despite the available evidence and the diagnostic potential, there remains a substantial proportion of rheumatologists for whom MRI and ultrasonography findings do not influence their clinical decision-making. This Perspectives will discuss the key issues related to diagnostic imaging in patients with chronic arthritis, outlining how new imaging techniques have evolved over the past two decades and presenting the most attractive technological advances in this field.
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Zardi EM, Taccone A, Marigliano B, Margiotta DP, Afeltra A. Neuropsychiatric systemic lupus erythematosus: Tools for the diagnosis. Autoimmun Rev 2014; 13:831-9. [DOI: 10.1016/j.autrev.2014.04.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/30/2014] [Indexed: 01/18/2023]
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Corrales A, González-Juanatey C, Peiró ME, Blanco R, Llorca J, González-Gay MA. Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: results of a population-based study. Ann Rheum Dis 2013; 73:722-7. [PMID: 23505241 DOI: 10.1136/annrheumdis-2012-203101] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine if the use of carotid ultrasonography (US) may improve the stratification of the cardiovascular (CV) risk in rheumatoid arthritis (RA). METHODS A set of 370 consecutive patients without history of CV events were studied to assess carotid intima-media thickness (cIMT) and plaques. As previously proposed, CV risk was calculated according to the modified EULAR systematic coronary risk evaluation (mSCORE) for RA that was adapted by the application of a multiplier factor of 1.5 in those patients fulfilling ≥ 2 of 3 specific criteria. RESULTS The mean disease duration was 9.8 years, 250 (68%) had rheumatoid factor/anticyclic citrullinated peptide positivity and 61 (17%) extra-articular manifestations. 43 were excluded because they had type 2 diabetes mellitus or severe chronic kidney disease. CV risk was categorised in the remaining 327 RA patients according to the mSCORE: mild (96 cases; 29.3%), moderate (201; 61.5%) and high/very high risk (30; 9.2%). Only five patients were reclassified as having high/very high CV risk when the mSCORE was applied. Severe carotid US abnormalities (cIMT >0.90 mm and/or plaques) were uncommon in patients with low mSCORE (13%). Nevertheless, in patients with moderate mSCORE, severe carotid US abnormalities were observed in 63% of cases. A model that included a chart mSCORE risk ≥ 5% plus the presence of severe carotid US findings in patients with moderate mSCORE risk (≥ 1% and <5%) yielded high sensitivity for high/very high CV risk (93 (95% CI 88 to 96)). CONCLUSIONS Our results support the use of carotid US in the assessment of CV risk in patients with RA.
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Affiliation(s)
- Alfonso Corrales
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, , Santander, Spain
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Naredo E, Moller I, Corrales A, Bong DA, Cobo-Ibanez T, Corominas H, Garcia-Vivar ML, Macarron P, Navio T, Richi P, Iagnocco A, Garrido J, Martinez-Hernandez D. Automated radiofrequency-based US measurement of common carotid intima-media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs. Rheumatology (Oxford) 2012; 52:376-81. [DOI: 10.1093/rheumatology/kes260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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