Determining the presence of Peripheral Arterial Disease in patients with Rheumatoid Arthritis

• Main Authors: Andrea C. Grech, Alfred Gatt, Andrew A. Borg, Cynthia Formosa
• Format: Article
• Language: English
• Published: PCO Convin S.A. 2017-01-01
• Series: Mediterranean Journal of Rheumatology
• Subjects: rheumatoid arthritis; ankle brachial pressure index; cardiovascular disease risk factors; screening
• Online Access: https://www.mjrheum.org/assets/files/792/file80_1019.pdf

Objectives: The aim of the study was to determine the manifestations of PAD in a population of RA participants with no history of cardiovascular events. Methods: A prospective observational non-experimental study was conducted on 100 participants presenting with RA and no history of significant cardiovascular events. Vascular assessment including Doppler spectral waveform analysis and Ankle Brachial Pressure Index was conducted. Results: Triphasic waveforms was found in the Posterior Tibial Artery (PT) in 70% right foot, 66% left foot and Dorsalis Pedis Artery (DP) in both feet in the64% of the patients. Twenty-nine per cent of the participants had biphasic PT right foot and 33% had biphasic PT left foot. Thirty-six per cent had biphasic DP both feet whilst only one participant (1%) had a discontinuous monophasic PT of both feet. The ABPI readings were found to be normal in 96% of participants and mild PAD was found in only 4% of the study population. Conclusions: Results indicate that whilst the ABPI index was normal in the majority of participants, waveform analysis was suboptimal (biphasic) in approximately one-third of the study sample. These findings highlight that the assessment of peripheral arterial perfusion should utilize both modalities to identify patients with early PAD.