Non-invasive assessment of coronary flow reserve and ADMA levels: a casecontrol study of early rheumatoid arthritis patients

Methods. The study involved 25 ERA patients (female/male 21/4; mean age 52.04 14.05 years; disease duration 12 months) and 25 healthy volunteers with no history or current signs of CAD or other traditional risk factors. Dipyridamole trans-thoracic stress echocardiography was preformed to evaluate CFR, and carotid ultrasound to measure the IMT of the common carotid arteries. Blood samples were obtained in order to assess ADMA levels before the patients had received any biological or non-biological DMARDs, or steroid therapy. Results. CFR was significantly reduced in the ERA patients (2.5 0.5 vs 3.5 0.8; P 0.01). In particular, 6/25 (24) had a CFR of 2 consistent with potentially dangerous coronary flow impairment. Common carotid IMT was significantly greater in the ERA patients, although still within the normal range (0.68 0.1 vs 0.56 0.11 mm; P 0.01). There was a significant correlation between CFR and plasma ADMA levels in the ERA population (r 0.53; P 0.01). IMT was negatively associated with CFR (P 0.05). Conclusions. Plasma ADMA levels were significantly higher in the ERA patients. A statistically significant negative effect of ADMA levels on CFR value was observed. The effect of ADMA levels on IMT is not significant.