The FMD was calculated automatically as the percent change in peak vessel diameter from the baseline value. The percentage of FMD (%FMD) was computed using the following formula: (maximum diameter – baseline diameter)/baseline diameter × 100%. Carotid artery studies were performed with the subject in the supine position with the neck extended and chin turned away from the side being examined. The IMT was scanned from the common carotid artery to the carotid bulbus on the right side. Three IMT measurements

were made, and the average was calculated (i.e., mean IMT), DAPT mw the single greatest value was defined as the “max IMT”. Intra- and inter-observer reliabilities were assessed by examining five healthy subjects. %FMD and max IMT were measured five times in each subject by two sonographers. Intra- and inter-observer reliabilities were estimated according to intraclass correlation coefficients (ICCs) calculated using one- and two-way analysis of variance (anova), respectively. The clinician and sonographer

JQ1 mw were blinded to each other’s findings throughout data collection. US, clinical, and laboratory tests were independently conducted. Differences between groups were examined using the Mann–Whitney U-test for continuous variables, or a chi-square test for categorized data when appropriate. Pearson’s correlation coefficients were calculated to determine the correlations between US and clinical parameters. A stepwise multivariate regression analysis was performed enough to elucidate the factors related to the%FMD of the 25 subjects. The following variables were assessed: age, disease duration, hyperlipemia, CRP and anti-TNF therapy. The results are expressed as mean ± standard error of mean (SE). The level of statistical significance was set at P < 0.05. Of the 25 subjects, 52.0% (13/25) received anti-TNF therapy (6 infliximab, 5 etanercept and 2 adalimumab), while 48.0% (12/25) received DMARDs

(6 methotrexate, 4 bucillamine and 2 sulfasalazine). The median dosing duration prior to the onset of anti-TNF therapy was 14 weeks (range, 2–50 weeks). According to the Steinbrocker[16] functional classification of RA, of the 25 patients with RA, 12.0%, 76.0% and 12.0% had classes I, II and III, respectively. Regarding disease stage, 4.0%, 40.0%, 32.0% and 24.0% had Steinbrocker[16] stages I, II, III and IV, respectively. Furthermore, 24% had hyperlipemia. The intra-observer reproducibility of both examinations was high (%FMD: Observer A, ICC = 0.9926, 95% confidence interval [CI] = 0.9744–0.9991, Observer B, ICC = 0.9946, 95% CI = 0.9812–0.9994; max IMT: Observer A, ICC = 0.9983, 95% CI = 0.9948–0.9998, Observer B, ICC = 0.9980, 95% CI = 0.9929–0.9998). The same trend was noted for inter-observer reproducibility (%FMD: ICC = 0.9976, 95% CI = 0.9775–0.9998; max IMT: ICC = 0.9986, 95% CI = 0.9864–0.9999). An ICC value > 0.9 was considered very good.