Effects of Rosuvastatin on Carotid Artery Plaques in Patients With Inflammatory Joint Disease
Status:
Completed
Trial end date:
2013-08-01
Target enrollment:
Participant gender:
Summary
Patients with rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are at greater risk
of developing cardiovascular disease. The reason(s) for this have not been well investigated,
but there is a general understanding that systemic inflammation plays a part in the increased
cardiovascular morbidity and mortality. In spite of the increased risk in these patients,
they have not been included as a high risk patient group in cardiovascular prevention
guidelines.
The investigators have carried out a cardiovascular study of RA and AS patients, as well as
patients with arthritis for the first time. The investigators have demonstrated cholesterol
plaques in the carotid artery in some of these patients. Plaques in the carotid artery
represent a risk for development of cerebral stroke and are significantly associated with
myocardial infarction. These plaques, which are asymptomatic and do not cause
haemodynamically significant narrowing, diameter reduction (i.e. operation is not indicated),
are vascular atheromatous disease. Therefore, according to prevailing cardiovascular
guidelines (SCORE 2007), these patients shall have secondary prevention with a lipid lowering
agent with the LDL-cholesterol goal of 1.8 mmol/L and HDL-cholesterol > 1.0 mmol/L for men
and > 1.1 mmol/L for women.
Statins are cholesterol-lowering drugs, and have been shown to reduce the risk of
cardiovascular disease significantly. In addition, reduction in the size of coronary plaques
has been induced by statins, when the LDL has been reduced to 1.6-1.8 mmol/l. Plaques in the
carotid or coronary arteries have not previously been treated and characterized in patients
with RA, AS and other inflammatory forms of arthritis.
The aim of this study is to treat patients with cholesterol plaques in the carotid artery
with cholesterol-lowering medication, in the form of Rosuvastatin for 18 months, and
characterize the effects on the plaques in the carotid and coronary arteries. In addition,
the investigators want to clarify the connection between plaques in the carotid and coronary
arteries in patients with RA, AS and other inflammatory forms of arthritis.