scholarly journals ATHEROSCLEROTIC LESION OF CAROTID ARTERIES IN RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

2019 ◽  
Vol 34 (1) ◽  
pp. 107-117
Author(s):  
V. O. Omelchenko ◽  
E. A. Letyagina ◽  
M. A. Korolev ◽  
T. I. Pospelova
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Cardiovascular Risk Factors ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cerebrovascular Event ◽  
Media Thickness ◽  
Rheumatoid Arthritis Activity

Introduction. Cardiovascular complications are more often observed in patients with rheumatoid arthritis. Available cardiovascular risk scales were developed for general population and provide in sufficiently adequate assessment of the cardiovascular event likelihood. Studying the risk factors in rheumatoid arthritis patients is necessary for timely diagnosis and prevention.Objective: To analyze the incidence of atherosclerotic lesions in the brachiocephalic arteries in patients with rheumatoid arthritis and associations of this pathology with cardiovascular risk factors.Material and Methods. Two hundred and twelve Caucasian patients with rheumatoid arthritis (age of 58.0 years [48.3; 65.0]; Disease Activity Score-28 of 4.96 [3.86; 5.85]) were included in our study. Patients had American College of Rheumatology-defined rheumatoid arthritis (1987 classification criteria). The ratio of women to men was 5.8 to 1. General clinical examination of patients, the identification of traditional cardiovascular risk factors, and the determination of disease activity were performed. The atherosclerotic progression was assessed by ultrasonography with carotid intima-media thickness measurement and atherosclerotic plaque detection. All patients gave written informed consent before enrollment into the study.Results. Atherosclerotic plaques were found in 59 patients (27.8%), predominantly in older individuals (66.0 [59.0; 73.0] versus 55.0 years [42.0; 61.0], p<0.001) and in men (51.6 versus 23.8% in women, p=0.001). Atherosclerotic plaques were detected in 46.3% of smokers versus 23.4% of non-smokers (p=0.003). Atherosclerotic plaques were more frequently detected in patients with type 2 diabetes mellitus (58.3 versus 26.0%, p=0.036), arterial hypertension (41.7 versus 5.0%, p<0.001), angina pectoris (73.1 versus 21.5%, p<0.001), past history of acute cerebrovascular event (83.3 versus 25.9%, p=0.008), and the presence of post-infarction cardiosclerosis (100.0 versus 26.6%, p=0.03). No atherosclerotic plaques were found in 48 non-climacteric women. Except for the level of rheumatoid factor, all parameters of rheumatoid arthritis activity did not demonstrate statistically significant differences between groups with and without atherosclerotic plaques. The intima-media thickness mainly correlated with age (rs=0.633, p<0.001) and was not associated with rheumatoid arthritis activity. After the use of age- and sex-specific ultrasound criteria, the proportion of patients with intima-media thickening increased from 34.9 to 58.0% (p<0.001). Prevalence rates of most cardiovascular risk factors were associated with age and gender.Conclusion. The present study identified the differences between the incidence rates of traditional risk factors in patients with rheumatoid arthritis compared with the corresponding values in world studies and generated comparable results with REMARKA study confirming a significance of studying this question in the context of the Russian population. The results, obtained in this study, improve understanding of the structure of risk factors in patients with rheumatoid arthritis and may provide the basis for the algorithm of curation of patient with high cardiovascular risk.

scholarly journals ATHEROSCLEROTIC LESION OF CAROTID ARTERIES IN RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

2019 ◽  
Vol 34 (1) ◽  
pp. 107-117
Author(s):  
V. O. Omelchenko ◽  
E. A. Letyagina ◽  
M. A. Korolev ◽  
T. I. Pospelova
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Cardiovascular Risk Factors ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cerebrovascular Event ◽  
Media Thickness ◽  
Rheumatoid Arthritis Activity

Introduction. Cardiovascular complications are more often observed in patients with rheumatoid arthritis. Available cardiovascular risk scales were developed for general population and provide in sufficiently adequate assessment of the cardiovascular event likelihood. Studying the risk factors in rheumatoid arthritis patients is necessary for timely diagnosis and prevention.Objective: To analyze the incidence of atherosclerotic lesions in the brachiocephalic arteries in patients with rheumatoid arthritis and associations of this pathology with cardiovascular risk factors.Material and Methods. Two hundred and twelve Caucasian patients with rheumatoid arthritis (age of 58.0 years [48.3; 65.0]; Disease Activity Score-28 of 4.96 [3.86; 5.85]) were included in our study. Patients had American College of Rheumatology-defined rheumatoid arthritis (1987 classification criteria). The ratio of women to men was 5.8 to 1. General clinical examination of patients, the identification of traditional cardiovascular risk factors, and the determination of disease activity were performed. The atherosclerotic progression was assessed by ultrasonography with carotid intima-media thickness measurement and atherosclerotic plaque detection. All patients gave written informed consent before enrollment into the study.Results. Atherosclerotic plaques were found in 59 patients (27.8%), predominantly in older individuals (66.0 [59.0; 73.0] versus 55.0 years [42.0; 61.0], p<0.001) and in men (51.6 versus 23.8% in women, p=0.001). Atherosclerotic plaques were detected in 46.3% of smokers versus 23.4% of non-smokers (p=0.003). Atherosclerotic plaques were more frequently detected in patients with type 2 diabetes mellitus (58.3 versus 26.0%, p=0.036), arterial hypertension (41.7 versus 5.0%, p<0.001), angina pectoris (73.1 versus 21.5%, p<0.001), past history of acute cerebrovascular event (83.3 versus 25.9%, p=0.008), and the presence of post-infarction cardiosclerosis (100.0 versus 26.6%, p=0.03). No atherosclerotic plaques were found in 48 non-climacteric women. Except for the level of rheumatoid factor, all parameters of rheumatoid arthritis activity did not demonstrate statistically significant differences between groups with and without atherosclerotic plaques. The intima-media thickness mainly correlated with age (rs=0.633, p<0.001) and was not associated with rheumatoid arthritis activity. After the use of age- and sex-specific ultrasound criteria, the proportion of patients with intima-media thickening increased from 34.9 to 58.0% (p<0.001). Prevalence rates of most cardiovascular risk factors were associated with age and gender.Conclusion. The present study identified the differences between the incidence rates of traditional risk factors in patients with rheumatoid arthritis compared with the corresponding values in world studies and generated comparable results with REMARKA study confirming a significance of studying this question in the context of the Russian population. The results, obtained in this study, improve understanding of the structure of risk factors in patients with rheumatoid arthritis and may provide the basis for the algorithm of curation of patient with high cardiovascular risk.

FRI0119 The predictive value of cardiovascular risk factors on carotid intima media thickness in rheumatoid arthritis

2013 ◽  
Vol 72 (Suppl 3) ◽  
pp. A410.2-A410
Author(s):  
D. F. Van Breukelen-van der Stoep ◽  
J. van Zeben ◽  
B. Klop ◽  
G.-J. M. van de Geijn ◽  
N. van der Meulen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Predictive Value ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

scholarly journals AB0191 ON WHICH FACTOR TO ACT TO REDUCE CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.3-1120
Author(s):  
L. Nacef ◽  
H. Ferjani ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
E. Labbene ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Active Smoking ◽  
Media Thickness ◽  
Modifiable Factors ◽  
Internal Carotid Arteries

Background:Patients with rheumatoid arthritis (RA) are at higher cardiovascular risk (CVR) than the general population due to chronic inflammation. Several factors, both modifiable and non-modifiable, can increase this risk. Intima-media thickness (IMT) was considered as a marker for atherosclerosis.Objectives:This study aimed to identify predictor factors of increasing IMT.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute. The socio-demographic data, biological and immunological parameters were collected.Framingham’s score quantified the cardiovascular risk at 10-years. Carotid Ultrasonography (US) using a high resolution B mode carotid measured intima-media thickness (IMT) as a subclinical marker of atherosclerosis. Carotid US was performed in the supine position, according to American Society of Echocardiography guidelines. IMT was measured in the left (LCC) and right (RCC) common carotid arteries, the left (LIC) and right (RIC) internal carotid arteries, and the left (LEC) and right (RIC) internal carotid arteries. An increased IMT was defined as ≥0.9 mm.We analyzed data by the SPSS statistical package. A p-value <0.05 was considered significant.Results:Of the 47 patients surveyed, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The duration disease was 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history (hypertension, diabetes or dyslipidemia) and 16.4% were active smokers. Among women, 43.6% were postmenopausal. ITM was significantly higher in men at LIC (0.037) and LEC (0.025). Older age was associated with increased ITM in LIC (p=0.046; r=0.295), LEC (p=0.05; r=0.412), RCC (p=0.034; r=0.317), and REC (p=0.009; r=0.382). The ITM for LCC, LIC, LEC, RCC, RIC, and REC was higher in postmenopausal women, with no significant difference (p=0.782, p=0.208, p=0.877, r=0.734, p=0.808, p=0.437, respectively).Among the modifiable factors, active smoking was associated with a higher ITM at the REC level (p=0.047). However, weight was not associated with an increased ITM (LCC: p=0.092; LIC: p=0.985; LEC: p=0.952; RCC: p=0.744; RIC: p=0.210; REC: p=0.510). In our study, there was no significant association between DAS28 disease activity or inflammatory marks and ITM (LCC: p=0.784; LIC: p=0.316; LEC: p=0.420; RCC: p=0.784; RIC: p=0.484; REC: p=0.754).Conclusion:In our study, the non-modifiable factors associated with increased ITM were advanced age and male gender. The modifiable factor impacting ITM was primarily active smoking. Surprisingly, disease activity and biological inflammation did not influence ITM.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.Disclosure of Interests:None declared

scholarly journals Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

2021 ◽  
Author(s):  
Eliana Portilla-Fernández ◽  
Shih-Jen Hwang ◽  
Rory Wilson ◽  
Jane Maddock ◽  
W. David Hill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dna Methylation ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Association Studies ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

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