%0 Journal Article
%T Implication of new atherosclerotic carotid plaques in the cardiovascular outcome of patients with rheumatoid arthritis
%A Miguel A Gonz¨˘lez-Gay
%A Carlos Gonz¨˘lez-Juanatey
%J Arthritis Research & Therapy
%D 2012
%I BioMed Central
%R 10.1186/ar3733
%X Rheumatoid arthritis (RA) is a disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) events. In this issue of Arthritis Research & Therapy, Zampeli and colleagues [1] longitudinally assessed the association with new carotid artery plaques in a series of non-diabetic patients with RA. Besides highlighting the expected influence of age and traditional CV risk factors, the authors highlighted the potential influence of corticosteroid use as an independent risk factor for new plaque formation in the follow-up of these patients [1]. This interesting study raises a series of points that deserve to be addressed.First, the importance of early detection of atherosclerosis in RA before the development of CV complications. In this regard, the detection of endothelial dysfunction by brachial ultrasonography and the presence of abnormally increased carotid artery intima-media thickness (IMT) and carotid plaques by carotid ultrasound constitute a major breakthrough as they allow the presence of subclinical atherosclerosis in patients with RA to be identified [2]. In this respect, a recent study confirmed a correlation between the presence of endothelial dysfunction (considered an early step in the atherogenesis process) and morphological data showing abnormally increased carotid IMT in RA patients with a disease duration of longer than 7 years [3]. However, carotid ultrasound is technically easier to perform than flow-mediated endothelium-dependent brachial ultrasound and, in the hands of trained professionals, is a technique with low interobserver variability. Furthermore, as observed in low- and intermediate-risk groups of non-rheumatic individuals [4], both carotid IMT and the presence of carotid plaques have proven to be good predictors of CV events in patients with RA [5,6].Second, in their study, Zampeli and colleagues [1] focused specifically on carotid plaques. With respect to this, carotid plaques constitute the best expression of
%U http://arthritis-research.com/content/14/2/105