Assessment of Aortic Stiffness in Patients with Rheumatoid Arthritis Using Pulse Wave Velocity: An Update Meta-analysis

Abstract

Backgrounds: Rheumatoid arthritis (RA) is a systemic autoimmune disease that confers one of the strongest risks for cardiovascular disease (CVD) morbidity and mortality than in general population. Pulse wave velocity (PWV) and augmentation index (AIx) are composite measures of arterial stiffness (AS) and associated with CV risk.

Aim of the study: The aim of this study was to systemically review the evidence regarding the relationship between PWV, AIx and RA, as well as underlying influential factors.

Methods: Eligible literatures were searched in PubMed, EMBASE and The Cochrane Library published up to February 28, 2019 in English. The pooled weight mean difference (WMD) with its 95% confidence interval (CI) was calculated using random-effect model analysis.

Results: A total of 38 studies were finally incorporated in the meta-analysis. The results indicated that, compared to controls, RA patients had significantly increased levels of carotid-femoral (cf)-PWV (WMD = 1.10 m/s, 95% CI: 0.84-1.35), brachial-ankle (ba)-PWV (WMD = 0.20 m/s, 95% CI: 0.12-0.28), cartoid-radial (cr)-PWV (WMD = 0.51 m/s, 95% CI: 0.23-0.79), AIx (WMD = 4.79%, 95% CI: 1.34-8.24) and AIx normalized to a 75 beats/minute heart rate (AIx@75) (WMD = 5.78%, 95% CI: 3.82-7.74) (all p <0.001). Meta-regression and subgroup analysis demonstrated significant association of cf-PWV with age, disease duration and erythrocyte sedimentation rate (ESR) in RA.

Conclusions: Overall, there is increased PWV level in patients with RA, and this alteration is associated with age, disease duration and ESR.

Keywords: Arterial stiffness; Meta-analysis; Pulse wave velocity; Rheumatoid arthritis.