Carotid Intima-Media Thickness and Narrowing in Rheumatoid Arthritis: Impact of Age, Diabetes, and Conventional Risk Factors.

Background: Rheumatoid arthritis (RA) has been linked to increased cardiovascular risk; however, whether RA independently contributes to subclinical atherosclerosis remains unclear. This study aimed to evaluate carotid intima-media thickness (IMT) and carotid narrowing in RA patients compared with controls and to examine their associations with conventional cardiovascular risk factors. Methods: A total of 73 RA patients and 78 healthy controls underwent carotid Doppler ultrasonography to assess IMT and carotid narrowing. Non-parametric analyses were used for between-group comparisons, and associations with clinical variables were evaluated within the RA cohort. Results: The median age was 55 years (IQR: 43-63) in the RA group and 61 years (IQR: 51-68) in controls (p = 0.012). No significant differences were observed in median right CCA IMT (RA: 0.070 mm [IQR: 0.060-0.081] vs. controls: 0.068 mm [IQR: 0.050-0.076]; p = 0.619) or left CCA IMT (RA: 0.065 mm [IQR: 0.051-0.079] vs. controls: 0.065 mm [IQR: 0.050-0.074]; p = 0.701). The prevalence of carotid narrowing was also comparable between groups (right CCA: 15.1% vs. 11.5%, p = 0.633). Within the RA cohort, age was positively correlated with right CCA IMT (Spearman's rho = 0.375, p = 0.001), and diabetes mellitus was associated with a higher prevalence of right CCA narrowing (34.8% vs. 6.0%, p = 0.003). Conclusions: Carotid IMT and narrowing were not significantly different between RA patients and controls. In this cohort, age and diabetes mellitus were more strongly associated with subclinical carotid atherosclerosis than RA status itself. These findings emphasize the importance of comprehensive cardiovascular risk assessment in RA patients, particularly focusing on traditional risk factors.