Carotid enlargement and serum levels of von Willebrand factor in rheumatoid arthritis: a follow-up study

This follow-up study aimed to evaluate the relationship between serum levels of von Willebrand factor (vWf) and common carotid intima–media thickness (IMT) in patients with rheumatoid arthritis (RA). In the initial assessment, 34 female rheumatoid arthritis patients and 30 sex- and age-matched controls were included. The relationship among vWf serum levels, cardiovascular risk factors, and inflammation was initially assessed. The effects of these variables on carotid IMT were evaluated 5 years later. There were no significant differences between the RA patients and the controls in terms of IMT at the first evaluation. Five years later, the carotid IMT increased more significantly in RA patients if compared to controls (p < 0.001). The progression of carotid IMT significantly correlated with erythrocyte sedimentation rate (ESR) (r = 0.368, p = 0.032) and C-reactive protein (r = 0.506, p = 0.002). The progression of carotid IMT did not significantly correlate with vWf serum levels in the RA patients, although, at initial and repeated measurements, it showed statistically higher values of vWF in the RA patients compared to the control group (p < 0.01). The RA patients displayed accelerated development of atherosclerosis, as indicated by the increased IMT of carotid artery. Increased serum levels of vWF may suggest its potential role in cardiovascular risk prediction in RA patients.