Predictors of atherosclerosis in rheumatoid arthritis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Ahmad ◽  
Garg ◽  
Dhar ◽  
Srivastava ◽  
Biswas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Disease Duration ◽  
Early Stage ◽  
Subclinical Atherosclerosis ◽  
Disease Onset ◽  
Intima Media Thickness ◽  
Qt Dispersion ◽  
Control Group ◽  
Age And Sex

Background: Atherosclerosis is emerging as an important complication of rheumatoid arthritis (RA), with coronary artery disease being projected as the major cause of mortality in these patients.This study was undertaken to evaluate the presence of subclinical atherosclerosis and to identify the risk factors of atherosclerosis in patients with RA. Patients and methods: All consecutive in- and out-patients of rheumatoid arthritis (n = 100) irrespective of the disease duration were included in the study. A group of 100 age and sex matched controls were also studied. Increased carotid intima media thickness (beyond the 75th percentile for age and sex), presence of plaques, ankle brachial pressure index and QT dispersion were deemed as non-invasive measures of atherosclerotic burden. Results: Fifty patients (50.0 %) with RA had evidence of subclinical atherosclerosis as compared to the control group (n = 11, 11 %); plaques were observed in 26 patients. Eighteen (36 %) of these developed this evidence within 1 - 5 years of disease onset. Low HDL levels among the conventional risk factors and advanced patient age, longer disease duration, greater number of involved joint areas, steroid use and indices of inflammation in particular in RA, were associated with subclinical atherosclerosis. Sustained inflammation was observed throughout the sub-group with atherosclerosis irrespective of the disease duration. Conclusions: RA is a pro-atherogenic state with the process of atherosclerosis initiated in the early stage of the disease. Besides the traditional risk factors, sustained inflammation contributes to atherogenesis.

scholarly journals Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098283
Author(s):  
María Lourdes Ladehesa-Pineda ◽  
Iván Arias de la Rosa ◽  
Clementina López Medina ◽  
María del Carmen Castro-Villegas ◽  
María del Carmen Ábalos-Aguilera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Structural Damage ◽  
Disease Duration ◽  
Linear Models ◽  
Axial Spondyloarthritis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cross Sectional

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

scholarly journals Cardiovascular System Changes and Related Risk Factors in Acromegaly Patients: A Case-Control Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaopeng Guo ◽  
Lu Gao ◽  
Shuo Zhang ◽  
Yilin Li ◽  
Yue Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Duration ◽  
Early Stage ◽  
Cardiovascular Complications ◽  
Control Group ◽  
Great Vessel ◽  
Healthy Weight ◽  
Great Vessels ◽  
Main Determinants ◽  
And Gender

Background. Cardiovascular complications are known to be the main determinants of reduced life expectancy and decreased quality of life in acromegaly patients. Our study aimed to provide insight into the cardiovascular changes that occur in acromegaly patients and to investigate the correlative risk factors.Methods. A total of 108 patients definitively diagnosed with acromegaly and 108 controls matched for age and gender were recruited into study and control groups, respectively. Standard echocardiography was performed on all of the participants, and data were collected and analyzed.Results. All acromegaly patients presented with structural cardiac changes, including a larger heart cavity, thicker myocardial walls, and increased great vessel diameters compared with the control group. Additionally, the acromegaly patients presented with reduced diastolic function. Aging and increased body mass index (BMI) were correlated with myocardial hypertrophy and diastolic dysfunction; a longer disease duration was correlated with larger great vessel diameters.Conclusions. Ageing and increased BMI are independent risk factors for acromegalic cardiomyopathy, and a long disease duration results in the expansion of great vessels. Increased efforts should be made to diagnose acromegaly at an early stage and to advise acromegaly patients to maintain a healthy weight.

scholarly journals Association of “hypertriglyceridemic waist” with increased 5-year risk of subclinical atherosclerosis in a multi-ethnic population: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peyman Namdarimoghaddam ◽  
Adeleke Fowokan ◽  
Karin H. Humphries ◽  
G. B. John Mancini ◽  
Scott Lear
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Early Stage ◽  
Smoking Status ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Cross Sectional ◽  
Media Thickness ◽  
Hypertriglyceridemic Waist ◽  
Traditional Risk Factors

Abstract Background Hypertriglyceridemic waist (HTGW), which incorporates measures of waist circumference and levels of triglyceride in blood, could act as an early-stage predictor to identify the individuals at high-risk for subclinical atherosclerosis. Previous studies have explored the cross-sectional association between HTGW and atherosclerosis; however, understanding how this association might change over time is necessary. This study will assess the association between HTGW with 5-year subclinical carotid atherosclerosis. Methods 517 participants of Aboriginal, Chinese, European, and South Asian ethnicities were examined for baseline HTGW and 5-year indices of subclinical atherosclerosis (intima media thickness (mm), total area (mm2), and plaque presence). Family history of cardiovascular disease, sociodemographic measures (age, sex, ethnicity, income level, maximum education), and traditional risk factors (systolic blood pressure, smoking status, total cholesterol, high-density lipoprotein cholesterol, body mass index) were incorporated into the models of association. These models used multiple linear regression and logistic regression. Results Baseline HTGW phenotype is a statistically significant and clinically meaningful predictor of 5-year intima media thickness (β = 0.08 [0.04, 0.11], p < 0.001), total area (β = 0.20 [0.07, 0.33], p = 0.002), and plaque presence (OR = 2.17 [1.13, 4.19], p = 0.02) compared to the non-HTGW group independent of sociodemographic factors and family history. However, this association is no longer significant after adjusting for the traditional risk factors of atherosclerosis (p = 0.27, p = 0.45, p = 0.66, respectively). Moreover, change in status of HTGW phenotype does not correlate with change in indices of atherosclerosis over 5 years. Conclusions Our results suggest that when the traditional risk factors of atherosclerosis are known, HTGW may not offer additional value as a predictor of subclinical atherosclerosis progression over 5 years.

scholarly journals Common atherosclerosis genetic risk factors and subclinical atherosclerosis in rheumatoid arthritis: the relevance of disease duration

2018 ◽  
Vol 39 (2) ◽  
pp. 327-336 ◽  
Author(s):  
Bartłomiej Kisiel ◽  
Robert Kruszewski ◽  
Aleksandra Juszkiewicz ◽  
Anna Raczkiewicz ◽  
Artur Bachta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Genetic Risk ◽  
Disease Duration ◽  
Subclinical Atherosclerosis ◽  
Genetic Risk Factors

scholarly journals Association of “Hypertriglyceridemic Waist” with Increased 5-Year Risk of Subclinical Atherosclerosis in a Multi-Ethnic Population: A Prospective Cohort Study

2020 ◽  
Author(s):  
Peyman Namdarimoghaddam ◽  
Adeleke O. Fowokan ◽  
Karin H. Humphries ◽  
G.B. John Mancini ◽  
Scott A. Lear
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Early Stage ◽  
Smoking Status ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Cross Sectional ◽  
Media Thickness ◽  
Hypertriglyceridemic Waist ◽  
Traditional Risk Factors

Abstract Background: Hypertriglyceridemic waist (HTGW), which incorporates measures of waist circumference and levels of triglyceride in blood, could act as an early-stage predictor to identify the individuals at high-risk for subclinical atherosclerosis. Previous studies have explored the cross-sectional association between HTGW and atherosclerosis; however, understanding how this association might change over time is necessary. This study will assess the association between HTGW with five-year subclinical carotid atherosclerosis.Methods: 517 participants of Aboriginal, Chinese, European, and South Asian ethnicities were examined for baseline HTGW and five-year indices of subclinical atherosclerosis (intima media thickness (mm), total area (mm2), and plaque presence). Family history of cardiovascular disease, sociodemographic measures (age, sex, ethnicity, income level, maximum education), and traditional risk factors (systolic blood pressure, smoking status, total cholesterol, high-density lipoprotein cholesterol, body mass index) were incorporated into the models of association. These models used multiple linear regression and logistic regression.Results: Baseline HTGW phenotype is a statistically significant and clinically meaningful predictor of five-year intima media thickness (b = 0.08 [0.04, 0.11], p < 0.001), total area (b = 0.20 [0.07, 0.33], p = 0.002), and plaque presence (OR = 2.17 [1.13, 4.19], p = 0.02) compared to the non-HTGW group independent of sociodemographic factors and family history. However, this association is no longer significant after adjusting for the traditional risk factors of atherosclerosis (p = 0.27, p = 0.45, p = 0.66, respectively). Moreover, change in status of HTGW phenotype does not correlate with change in indices of atherosclerosis over five years.Conclusions: Our results suggest that when the traditional risk factors of atherosclerosis are known, HTGW may not offer additional value as a predictor of subclinical atherosclerosis over five years. Changes in HTGW may not be a reliable progress metric for prevention programs.

scholarly journals FRI0063 LEVEL OF N-TERMINAL FRAGMENT OF BRAIN NATRIURETIC PEPTIDE PROGENITOR AND ATHEROSCLEROTIC DAMAGE OF BRACHIOCEPHALIC ARTERIES IN PATIENTS WITH EARLY AND LONG-STANDING ACTIVE RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 608.2-608
Author(s):  
H. Gerasimova ◽  
T. Popkova ◽  
M. Cherkasova ◽  
E. Markelova ◽  
S. Glukhova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Natriuretic Peptide ◽  
Disease Duration ◽  
Atherosclerotic Lesion ◽  
Control Group ◽  
Early Ra ◽  
Terminal Fragment ◽  
Traditional Risk Factors ◽  
Brachiocephalic Arteries

Background:The high prognostic significance of the N-terminal fragment of the B-type natriuretic peptide (NT-proBNP) concentration in the development of cardiovascular diseases (CVD) was identified for rheumatoid arthritis (RA) patients (pts) and general population.Objectives:To investigate the significance of NT-proBNP levels in pts with early untreated and long-standing RA with high disease activity; to identify potential relationship of NT-pro-BNP levels with atherosclerotic lesion of the brachiocephalic arteries (BCA), traditional risk factors and inflammatory markers.Methods:A total of 227 RA pts (76%females, 24%males, 55 [46;61]years old, moderate to high activity (DAS28-5,3[4,6;6,3], SDAI–27(22;35), positive for ACCP (73%)/RF (87%),) were enrolled in the study: 136 pts with early RA (disease duration ≤12 months) and 91 pts with long-standing RA (>12 months). All early RA pts were not treated with glucocorticoids and disease-modifying antirheumatic drugs (DMARDs). Long-standing RA pts already developed the lack of efficacy/resistance and/or intolerance of DMARDs. Lack of efficacy of 3 or more DMARDs was established in 46% of pts, intolerance to previous DMARDs therapy - in 54% pts. 73% were receiving methotrexate, 21% - leflunomide, 7% - sulfasalazine, 46% glucocorticoids. Pts with early and long-standing RA were comparable in terms of age, sex, body mass index and RA activity rates (DAS28, SDAI, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels). High incidence of traditional risk factors was found in early and long-standing RA pts: the incidence rate of arterial hypertension (58%vs68%), overweight (58%vs61%), smoking (27%vs17%), DM type 2 (4%vs7%) were not significantly different. Pts with congestive heart failure were not include in the study. The control group consisted of 20 healthy donors, matched to pts by age and sex. Serum levels of NT-proBNP (pg/mL) were measured using electrochemiluminescence test Elecsys proBNP II (Roche Diagnostics, Switzerland). NT-proBNP levels > 125,0 pg/mL were considered as elevated. The BCA intima-media thickness (IMT) was assessed by duplex ultrasound scanning. Atherosclerotic lesion of BCA was documented in the presence of plaque (IMT≥1,2mm).Results:The NT-proBNP levels were significantly higher in RA pts than in the control group (median 92,1 (48,2-164,7) pg/mL vs 55,3 (36,6-67,3) pg/mL,p<0.05). Pts with early RA had higher NT-proBNP levels (118,9 (60,2-201,3) pg/ml) than pts with long-standing RA (73,4 (43,0-114,3) pg/ml,p<0,001). Elevated NT-proBNP concentrations were found in 71 (52%) early RA pts vs 21 (23%) pts with long- standing RA (р<0,01). Atherosclerotic lesion of the BCA was detected in 73 (54%) pts with early RA and in 37 (41%) pts with long- standing RA (p>0,05). The NT-proBNP levels correlated with age (r=0,51,p<0,001), CRP (0,23,p=0,001) and IMT of BCA (r=0,46,p=0,03) in RA pts. Aforementioned correlations were significantly remained for both groups of RA pts. Association between IMT of BCA and CRP concentrations was not found.Conclusion:NT-pro-BNP levels are higher in pts with active RA than in control subjects. Early untreated RA pts had a higher NT-proBNP levels than pts with disease duration >12 months and resistance or intolerance of DMARDs. The increased concentration NT-pro-BNP (>125pg/ml) were found in half of pts with early untreated RA and every fourth pts with long-standing active RA. NT-proBNP concentration correlated with CRP level in pts with active RA. Correlation between NT-pro-BNP concentrations and IMT of BCA may be indicative of possible impact of this biomarker on atherosclerotic damage of BCA in pts with early and long-standing active RA.Disclosure of Interests:None declared

Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Intervention Group ◽  
Serum Levels ◽  
Control Group ◽  
Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

Subclinical atherosclerosis in children and adolescents with congenital heart disease

2020 ◽  
pp. 1-8
Author(s):  
Silvia M. Cardoso ◽  
Michele Honicky ◽  
Yara M. F. Moreno ◽  
Luiz R. A. de Lima ◽  
Matheus A. Pacheco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Congenital Heart ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

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