scholarly journals The prevalence of subclinical atherosclerosis of carotid arteries in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis (pilot study)

2021 ◽  
Vol 15 (5) ◽  
pp. 33-38
Author(s):  
M. S. Eliseev ◽  
O. V. Zhelyabina ◽  
A. M. Novikova ◽  
M. N. Chikina ◽  
E. I. Markelova ◽  
...  
Keyword(s):  
Carotid Arteries ◽  
Subclinical Atherosclerosis ◽  
Blood Pressure Level ◽  
Intima Media Thickness ◽  
Blood Lipid ◽  
Calcium Pyrophosphate ◽  
Crystal Deposition ◽  
Timely Initiation ◽  
Crystal Deposition Disease ◽  
Deposition Disease

To this date there have been no studies of subclinical atherosclerosis in the patients with calcium pyrophosphate crystal deposition disease (CPPD); in osteoarthritis (OA) such works are rare.Objective: to assess the prevalence of subclinical atherosclerosis of carotid arteries (CA) in patients with CPPD and OA.Patients and methods. The case-control study included 26 patients with CPPD and OA. The diagnosis of CPPD was based on the criteria of D.J. McCarty, diagnosis of OA was based on national clinical practice guidelines. We recorded data on smoking, blood pressure level. Assessed blood lipid spectrum, serum levels of glucose, creatinine, uric acid, CRP. Obesity was diagnosed in accordance with the WHO recommendations. All patients underwent CA Doppler ultrasonography (DUS). An increase in intima-media thickness (IMT) >0.9 mm was considered a manifestation of subclinical atherosclerosis. The SCORE index was calculated for all patients.Results and discussion. The median serum CRP level was comparable in CPPD and OA. The CRP level >5 mg/L was detected in 8 patients with CPPD and in 3 patients with OA (p=0.09). Initial signs of atherosclerosis were present in 11 (42%) patients with CPPD and in 8 (31%) patients with OA (p=0.39). In CPPD, an increase in IMT was associated with a CRP level of ≥5 mg/L in 19% of cases, and in OA – in 12.5% (p=0.08). An increase in IMT >1.3 mm was not found in patients of both groups.Conclusion. In patients with CPPD and OA, subclinical atherosclerosis is often present according to the CA ultrasound. Early detection of uncomplicated subclinical atherosclerosis in CPPD and OA is necessary for timely initiation of treatment aimed to prevent the progression of atherosclerosis and the development of cardiovascular diseases.

Effect of colchicine, methotrexate, and hydroxychloroquine therapy on cardiovascular outcomes in patients with calcium pyrophosphate crystal deposition disease

2021 ◽  
Vol 15 (6) ◽  
pp. 76-83
Author(s):  
M. S. Eliseev ◽  
E. V. Cheremushkina ◽  
O. V. Zhelyabina ◽  
M. N. Chikina ◽  
A. A. Kapitonova ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Serum Uric Acid Level ◽  
Calcium Pyrophosphate ◽  
Chronic Arthritis ◽  
Cardiovascular Outcomes ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Deposition Disease ◽  
History Of ◽  
Anti Inflammatory

Anti-inflammatory therapy, such as colchicine (COL), has been suggested to affect the incidence of cardiovascular events in patients with calcium pyrophosphate crystal deposition disease (CPPD).Objective: to study the effect of anti-inflammatory therapy with COL, hydroxychloroquine (HC), and methotrexate (MT) on cardiovascular outcomes in patients with CPPD.Patients and methods. The study included 305 patients with CPPD, the majority (62.30%) were women. The average follow-up period was 3.9±2.7 years. Among factors influencing cardiovascular outcome were considered: gender; age; smoking; alcohol intake >20 conventional doses per week; arterial hypertension; a history of cardiovascular diseases (CVD), in particular ischemic heart disease, acute myocardial infarction, acute cerebrovascular accident, chronic heart failure >III stage according to NYHA, as well as type 2 diabetes mellitus (DM); body mass index >25 kg/m2 and >30 kg/m2; cholesterol level (CHOL) >5.1 mmol/l; glomerular filtration rate (GFR) < 60 ml/min/1.73 m2; serum uric acid level >360 μmol/l; hypercalcemia (serum calcium level >2.62 mmol/L); CRP level >2 mg/l; the presence of hyperparathyroidism (parathyroid hormone level >65 pg/ml); CPPD phenotypes (asymptomatic, osteoarthritis with calcium pyrophosphate crystals, chronic arthritis, acute arthritis); intake of COL, HC, MT, glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs).Results and discussion. 264 patients were under dynamic observation. Any of the studied cardiovascular events were registered in 79 (29.9%) patients. During the observation period, 46 (17.4%) patients died, in 76.1% of cases the cause of death was CVD. Death from other causes was diagnosed in 11 (23.9%) patients. Non-fatal cardiovascular events were reported in 44 (16.7%) cases. The risk of cardiovascular events was higher in patients over 65 years of age (odds ratio, OR 5.97; 95% confidence interval, CI 3.33–10.71), with serum cholesterol levels ≥5.1 mmol/L (OR 1,95; 95% CI 1.04–3.65), GFR <60 ml/min/1.73 m2 (OR 2.78; 95% CI 1.32–5.56), history of CVD (OR 2,32; 95% CI 1.22–4.44). COL therapy reduced the risk of cardiovascular events (OR 0.20; 95% CI 0.11–0.39).Conclusion. Poor CVD outcomes in CPPD are associated with age, hypercholesterolemia, chronic kidney disease, and a history of CVD. The use of COL, in contrast to MT and HC, was accompanied by a decrease in cardiovascular risk.

FLEXOR TENDON RUPTURE OF THE LITTLE FINGER CAUSED BY CALCIUM PYROPHOSPHATE DIHYDRATE CRYSTAL DEPOSITION DISEASE OF THE PISOTRIQUETRUM JOINT

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 413-415 ◽  
Author(s):  
Takuma Wakasugi ◽  
Ritsuro Shirasaka ◽  
Hiroaki Kimura ◽  
Yoshiaki Wakabayashi
Keyword(s):  
Flexor Tendon ◽  
Calcium Pyrophosphate ◽  
Calcium Pyrophosphate Dihydrate ◽  
Distal Stump ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Deposition Disease ◽  
Closed Rupture ◽  
Pyrophosphate Dihydrate ◽  
Little Finger

We report a case of closed rupture of the flexor tendons of the little finger caused by calcium pyrophosphate dihydrate crystal deposition disease of the pisotriquetrum joint. The patient could not flex the little finger and did not have wrist pain. Plain radiographs of the affected wrist joint showed severe arthritic changes of the pisotriquetrum joint and calcification around the joint. At operation, the pisotriquetrum joint capsule was ruptured and involved the flexor tendon of the little finger. The distal stump of the flexor tendon was transferred to the flexor tendon of the ring finger, and the pisiform was resected. Histological examination with polarized light microscopy revealed crystals showing weakly positive birefringence in the calcification.

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