Key result
Polymyalgia rheumatica was associated with significantly increased subclinical vascular damage, including higher intima-media thickness (1.07 vs 0.8 mm, p=0.0001) compared to controls with cardiovascular risk factors alone.
Why the study?
The study was conducted to investigate the presence of subclinical vascular damage in polymyalgia rheumatica.
Does polymyalgia rheumatica increase subclinical vascular damage in patients with major cardiovascular risk factors?
Cross-Sectional (n=104)
No
Does polymyalgia rheumatica increase subclinical vascular damage in patients with major cardiovascular risk factors?
Patients with polymyalgia rheumatica exhibit increased subclinical vascular damage and arterial stiffness compared to controls with similar cardiovascular risk factors, highlighting the potential need for targeted primary cardiovascular prevention.
Answers are grounded in this paper and cite their sources.
May warrant closer vascular surveillance in polymyalgia rheumatica; leaves open whether it predicts events or alters management.
The aim of the study was to investigate the presence of subclinical vascular damage in polymyalgia rheumatica (PMR). We enrolled PMR patients having major cardiovascular risk factors (MCVRF) and, as controls, patients with MCVRF. All underwent: color Doppler ultrasound to evaluate the common carotid intima-media thickness (IMT), the anterior–posterior abdominal aortic diameter (APAD), and the prevalence of carotid artery stenosis; the cardio-ankle vascular index (CAVI) to measure arterial stiffness together with the ankle-brachial index (ABI) to investigate the presence of lower-extremity peripheral arterial disease. Finally, we measured the serum levels of adipocytokines implicated in vascular dysfunction. As a result, 48 PMR and 56 MCVRF patients were included. An increase of IMT (1.07/0.8–1.2 vs 0.8/0.8–1.05; p = 0.0001), CAVI (8.7/7.8–9.3 vs 7.6/6.9–7.8; p < 0.0001) and APAD values (21.15/18.1–25.6 vs 18/16–22; p = 0.0013) was found in PMR patients with respect to controls. No differences were reported in the prevalence of carotid artery stenosis or ABI values between the two groups. A significant correlation between IMT and CAVI in PMR and MCVRF subjects (r 2 = 0.845 and r 2 = 0.556, respectively; p < 0.01) was found. Leptin levels (pg/mL; median/25th–75th percentile) were higher in PMR than in MCVRF subjects (145.1/67–398.6 vs 59.5/39.3–194.3; p = 0.04). Serum levels of adiponectin (ng/mL) were higher in PMR patients (15.9/10.65–24.1 vs 6.1/2.8–22.7; p = 0.01), while no difference in serum levels of resistin (ng/mL) was found between PMR and MCVRF subjects (0.37/0.16–0.66 vs 0.26/0.14–1.24). Our study shows an increased subclinical vascular damage in PMR patients compared to those with MCVRF, paving the way for further studies aimed at planning primary cardiovascular prevention in this population.
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Scrivo et al. (2020) conducted a cross-sectional in Polymyalgia rheumatica (n=104). Polymyalgia rheumatica vs. Major cardiovascular risk factors without polymyalgia rheumatica was evaluated on Common carotid intima-media thickness (IMT) in mm (p=0.0001). Polymyalgia rheumatica was associated with significantly increased subclinical vascular damage, including higher intima-media thickness (1.07 vs 0.8 mm, p=0.0001) compared to controls with cardiovascular risk factors alone.
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