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Rosuvastatin induced carotid plaque regression in patients with inflammatory joint diseases: The RORA-AS study

Session Poster Session III - Friday 08:30 - 12:30

Speaker Silvia Rollefstad

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Lipids
  • Session type : Poster Session

Authors : S Rollefstad (Oslo,NO), E Ikdahl (Oslo,NO), J Hisdal (Oslo,NO), IC Olsen (Oslo,NO), I Holme (Oslo,NO), HB Hammer (Oslo,NO), GD Kitas (West Midlands,GB), TR Pedersen (Oslo,NO), TK Kvien (Oslo,NO), AG Semb (Oslo,NO)

S Rollefstad1 , E Ikdahl1 , J Hisdal2 , IC Olsen3 , I Holme4 , HB Hammer3 , GD Kitas5 , TR Pedersen6 , TK Kvien3 , AG Semb1 , 1Diakonhjemmet Hospital, Preventive Cardio-Rheuma Clinic, Department of Rheumatology - Oslo - Norway , 2Oslo University Hospital, Aker, Section of Vascular Investigations - Oslo - Norway , 3Diakonhjemmet Hospital, Department of Rheumatology - Oslo - Norway , 4Oslo University Hospital, Ullevaal, Department of biostatistics, epidemiology and health economics - Oslo - Norway , 5Dudley Group NHS Foundation Trust - West Midlands - United Kingdom , 6Oslo University Hospital, Ullevaal, Centre of Preventive Medicine - Oslo - Norway ,


Purpose: Patients with rheumatoid arthritis (RA) and carotid artery plaques (CP) have increased risk of acute coronary syndromes. Statin treatment with low density lipoprotein cholesterol (LDL-c) goal < 1.8 mmol/L is recommended for patients with CP in the general population. In the ROsuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and other inflammatory joint diseases (RORA-AS) study, the aim was to evaluate the effect of 18 months intensive lipid lowering with rosuvastatin on change in CP height.
Methods: Eighty-six patients (60.5% female) with CP and IJD [RA (n=55), ankylosing spondylitis (n=21) and psoriatic arthritis (n=10)] were treated with rosuvastatin to obtain LDL-c goal. CP height was evaluated by B–mode ultrasound.
Results: Age was 60.8±8.5 years (mean±SD). At baseline, median number and height of CP was 1.0 (range 1-6) and 1.80 mm (IQR 1.60, 2.10). Change in CP height after 18 months rosuvastatin treatment was -0.19±0.35 mm (p<0.001). Baseline and change in LDL-c was 4.0±0.9 mmol/L and -2.3±0.8 mmol/L (p<0.001). Mean LDL-c level during 18 months rosuvastatin treatment was 1.7±0.4 mmol/L. The degree of CP height reduction was independent of the LDL-c level exposure during the study period (p=0.36). Attainment of LDL-c < 1.8 mmol/L or the change in LDL-c did not influence the degree of CP height reduction (p=0.44 and p=0.46, respectively). The higher the CP was at baseline - the larger height reduction after 18 months with rosuvastatin treatment (p< 0.001). Joint disease activity during the study period was inversely associated with change in CP height (p=0.02), so that patients with the highest disease activity had the smallest change in CP height and vice versa.
Conclusion: This is the first clinical study showing that intensive lipid lowering with statin induced regression of atherosclerosis in patients with IJD. Our results indicate that joint disease activity may influence the effect of anti-atherosclerotic treatment.

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