PathologyMales With Rheumatoid Arthritis Often Evidence Carotid Atheromas on Panoramic Imaging: A Risk Indicator of Future Cardiovascular Events
Section snippets
Study Design and Patient Sample
To address these research questions, we designed and implemented a retrospective observational study. The study was conducted in accordance with the Declaration of Helsinki guidelines. The institutional review board of the Veterans Affairs Greater Los Angeles Healthcare System approved the study protocol, and the need for informed consent from each subject was waived, given the retrospective nature of the project, its use of de-identified patient data, anonymous coding of information with the
Results
A total of 100 male patients (mean age 69.89 ± 8.92 years) with a diagnosis of RA and a confirmatory positive RF titer value (RF >20 IU/mL) were enrolled in our study. Of these, 29 (mean age 72.10 ± 7.68 years) evidenced an atheroma (CCAP+) on their panoramic radiographic image (Fig 1). The images of 4 additional subjects were deemed positive by only 1 of the 2 clinicians and thus were not calculated as positive for CCAP+. This rate was significantly greater (P = .00001) than the 3% evidenced
Discussion
The results of our study demonstrated a very high prevalence rate of calcified atheromas on the panoramic images of patients with RA and its association with very high titers of biologic markers of inflammation. The 29% CCAP+ prevalence rate is almost 10 times greater than that demonstrated among a similarly aged male cohort studied in 1994 in the same oral-maxillary surgery clinic.19 The implication of these findings are striking given that CCAPs seen on panoramic images, a previously
Oral and Maxillofacial Surgery Considerations
The presence of CCAPs on the panoramic images of patients with RA is indicative of immune-mediated major extra-articular comorbidities that can negatively affect the outcomes of ambulatory and in-hospital anesthetic and maxillofacial surgical procedures. The presence of such lesions is indicative of a high risk of MI and stroke, even among individuals not stressed by the surgical environment.20 The persistent systemic inflammation responsible for the development of the atherosclerotic disease
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Panoramic radiography for detection of bilateral carotid calcified atheroma: An unusual case report
2020, Journal of Oral Research
The present report is the result of the work supported with resources from, and the use of facilities at, the Veterans Affairs Greater Los Angeles Healthcare System. Its contents do not represent the views of the US Department of Veterans Affairs or the US Government.
Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.