Inflammation and Microvascular and Macrovascular Endothelial Dysfunction in Rheumatoid Arthritis: Effect of Treatment

2010 ◽  
Vol 37 (4) ◽  
pp. 711-716 ◽  
Author(s):  
WILL FOSTER ◽  
DAVID CARRUTHERS ◽  
GREGORY Y.H. LIP ◽  
ANDREW D. BLANN
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Dysfunction ◽  
Vascular Function ◽  
Venous Blood ◽  
Microvascular Function ◽  
Control Group ◽  
Antirheumatic Therapy ◽  
Antiinflammatory Therapy ◽  
Patients With Diabetes ◽  
Plasma Markers

Objective.To determine whether abnormalities in microvascular and macrovascular function in rheumatoid arthritis (RA) are associated with plasma markers [von Willebrand factor (VWF)] of endothelial dysfunction and inflammation [C-reactive protein (CRP)] and whether the abnormalities would be altered by treatment. Endothelial dysfunction and inflammation in RA may contribute to adverse cardiovascular events. Although endothelial dysfunction in RA has been demonstrated by altered plasma markers, the relationships with macrovascular and microvascular function are relatively unexplored.Methods.We recruited 66 patients with chronic RA, 48 community controls (CC), and 25 patients with diabetes and hypertension as a disease control group (DC). Subjects had venous blood sampled for plasma markers, and underwent laser Doppler perfusion imaging of forearm skin (to assess microvascular circulation) following acetylcholine and sodium nitroprusside iontophoresis, to assess endothelium-dependent and endothelium-independent responses, respectively. Brachial artery flow-mediated dilatation assessed endothelial dysfunction in a macrovascular bed. A subgroup of 29 patients with RA were assessed pretherapy and after 2–4 weeks of antirheumatic therapy.Results.As expected, patients with RA had higher CRP, erythrocyte sedimentation rate (ESR), and VWF. Endothelium-independent vasoreactivity was abnormal in RA, and this correlated negatively with CRP. All aspects of microvascular function were abnormal in the DC compared to the CC. Macrovascular function was preserved in RA but was abnormal in the DC group. Four weeks of antiinflammatory therapy reduced CRP and ESR but had no effect on any vascular function index in the patients with RA.Conclusion.Patients with RA have abnormal endothelium-independent microvascular function that correlates with inflammation but is not altered by short-term antiinflammatory therapy.

Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatih Öner Kaya ◽  
Yeşim Ceylaner ◽  
Belkız Öngen İpek ◽  
Zeynep Güneş Özünal ◽  
Gülbüz Sezgin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Volunteers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Control Group ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Das 28 ◽  
Tnf Α

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

scholarly journals Vascular Function and Inflammation in Rheumatoid Arthritis: the Role of Physical Activity

2010 ◽  
Vol 4 (1) ◽  
pp. 89-96 ◽  
Author(s):  
George S. Metsios ◽  
Antonios Stavropoulos Kalinoglou ◽  
Aamer Sandoo ◽  
Jet J.C.S. Veldhuijzen van Zanten ◽  
Tracey E. Toms ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Endothelial Dysfunction ◽  
Vascular Function ◽  
Necrosis Factor Alpha ◽  
Reactive Protein ◽  
Non Invasive ◽  
Increased Risk ◽  
Invasive Techniques

Inflammation disturbs biochemical pathways involved in homeostasis of the endothelium. Research has established clear links between inflammatory mediators, particularly C-reactive protein and tumour necrosis factor alpha, endothelial dysfunction, and atherosclerosis. Endothelial dysfunction and atherosclerosis may be subclinical at early stages, and thus the ability to detect them with non-invasive techniques is crucially important, particularly in populations at increased risk for cardiovascular disease, such as those with rheumatoid arthritis. This may allow the identification of interventions that may reverse these processes early on. One of the best non-pharmacological interventions that may achieve this is physical activity. This review explores the associations between inflammation, endothelial dysfunction, and atherosclerosis and discusses the role of exercise in blocking specific pathways in the inflammation, endothelial dysfunction - atherosclerosis network.

scholarly journals THE STRUCTURAL FEATURES OF VASCULAR ENDOTHELIUM IN ACUTE CEREBRAL ISCHEMIA

2017 ◽  
Vol 3 ◽  
pp. 32-37
Author(s):  
Anna Kosheleva
Keyword(s):  
Endothelial Dysfunction ◽  
Vascular Endothelium ◽  
Middle Age ◽  
Venous Blood ◽  
Control Group ◽  
Peripheral Venous Blood ◽  
Symptomatic Carotid ◽  
Endothelin 1 ◽  
Acute Cerebral Ischemia ◽  
In Cis

The aim of the research was to study the number and structural properties of desquamated endothelial cells (DECs) in the peripheral blood in carotid ischemic stroke (CIS) and carotid transient ischemic attacks (TIAs) and its connection with the marker of endothelial dysfunction - endothelin-1. We examined 35 patients with the first CIS, on days 1st and 10th, and also 34 patients with symptomatic carotid TIAs, on days 1st and 10th of the observation. Middle age of the examined patients with a CIS was 63,7±1,0. Middle age of the examined patients with the ТIАs was 54,7±1,0. 25 practically healthy persons were examined as a group of control. Neurologic deficit was assessed with the National Institutes of Health Stroke Scale (NIHSS). DECs were estimated by CD34 immunobead capture in the peripheral venous blood of patients and persons of control group. We studied the level of endothelin-1 in the peripheral venous blood of patients and persons of control group using the enzyme immunoassay using the Biomedica (Austria) during the first 24 hrs and on day 10. Statistical processing of the obtained results was carried out using statistical analysis package Statistica. In this case, the mean value, the standard error and the correlation analysis were determined. Samples were compared using the Student's criterion (t) and the correlation coefficient (r). During an examination of 35 patients in the acute period of CIS and 34 patients with carotid TIAs using the immunocytochemical method the number of DECs was studied in venous blood. The quantitative analysis of vascular endothelium in acute cerebral ischemias showed its statistically unreliable differences in CIS and TIAs. A conclusion is drawn about the general mechanisms of endothelial dysfunction in CIS and TIAs. The number of DECs significantly correlates with the terms of disease. Regress of this indicator is noted in patients by the end of follow-up in both observation groups. During the first 24 hrs in patients with CIS and TIAs density of DECs of blood directly correlates with the level of endothelin-1 blood. The endothelin-1 level tends to decrease by the 10th day of observation and the correlation force with the DECs level is correspondingly reduced.

scholarly journals SAFETY AND EFFECTIVENESS OF TRI VALENT INACTIVATED SPLIT VIRION INFLUENZA VACCINE IN PATIENTS WITH RHEUMATOID DISORD ERS

The Clinician ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 25-28
Author(s):  
D. V. Bukhanova ◽  
В. S. Belov ◽  
G. M. Tarasova ◽  
Sh. F. Erdes ◽  
T. V. Dubinina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Influenza Vaccine ◽  
Clinical Effectiveness ◽  
Control Group ◽  
Low Grade ◽  
Antirheumatic Therapy ◽  
Post Vaccination ◽  
Flu Virus ◽  
Study Inclusion

Objective: to evaluate the safety and effectiveness of vaccination with trivalent split virion influenza vaccine in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), estimate the effect of vaccination on rheumatoid disorder (RD) activity and influenza and influenzalike illnesses morbidity.Materials and methods. The study included 86 patients (58 females and 28 males aged 22–82 years) with RDs (52 patients with RA and 34 patients with AS), as well as 40 subjects without RD (control group). At the time of study inclusion, all patients were receiving drug therapy. Duration of RD varied from 2 months to 46 years. The Vaxigrip vaccine containing the currents trains of the flu virus for 2016–2017 season or 2017–2018 season was administered subcutaneously as 1 dose (0.5 ml) with continuing antirheumatic therapy. The main control stages were visits 1, 3, and 6 months after vaccination. During the visits, standard clinical and labtests, clinical examination with disease activity evaluation were performed.Results. In 98 patients, vaccination tolerability was high, no post vaccination reactions were observed. In 20 cases, pain, swelling, and hyperemia of the skin 2 cm in diameter at the point of vaccination were observed; in 8 cases, low-grade fever, myalgia, discomfort, headache were observed. No RD flares or development of new autoimmune disorders were diagnosed during the follow-up period. No cases of influenza or influenza-like illnesses were registered during the follow-up period.Conclusion. The obtained data demonstrate high tolerability, clinical effectiveness of trivalent split virion influenza vaccine in patients with RA and AS.

Clinical Improvement in Rheumatoid Arthritis Is Associated with Healthier Microvascular Function in Patients Who Respond to Antirheumatic Therapy

2010 ◽  
Vol 37 (3) ◽  
pp. 521-528 ◽  
Author(s):  
BERNAT GALARRAGA ◽  
JILL J.F. BELCH ◽  
TOM PULLAR ◽  
SIMON OGSTON ◽  
FAISEL KHAN
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Function ◽  
Drug Treatment ◽  
Disease Activity ◽  
Microvascular Function ◽  
Doppler Imaging ◽  
Antirheumatic Therapy ◽  
Microvascular Endothelial ◽  
Cv Disease ◽  
Microvascular Endothelial Function

Objective.Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) mortality. Microvascular endothelial dysfunction occurs early in the development of CV disease and is worsened by inflammation. The effect of drug treatment for RA on microvascular function has been poorly studied. We assessed the effect of antirheumatic treatment on microvascular endothelial function in patients with RA, particularly to examine responders versus nonresponders to therapy.Methods.Fifty-one patients with active RA and no previous history of CV disease were assessed at baseline and after 2 and 4 months’ therapy with either anti-tumor necrosis factor-α drugs (etanercept, n = 27, adalimumab, n = 3) or methotrexate, n = 21. RA disease activity, inflammatory measures, and skin microvascular responses, measured using laser Doppler imaging after iontophoretic delivery of acetylcholine (ACh) and sodium nitroprusside (SNP), were assessed at each study visit.Results.Disease Activity Score (DAS28) decreased significantly from baseline to visit 2 and 3 (6.04 ± 1.2, 4.34 ± 1.3, 4 ± 1.3, respectively; p < 0.0001). Endothelium-dependent (ACh) and independent (SNP) responses for the whole cohort did not improve significantly after drug treatment (p = 0.250, p = 0.062, respectively). When patients who responded to antirheumatic therapy (n = 31) were analyzed, there were significant improvements in both ACh (p = 0.028) and SNP responses (p = 0.019).Conclusion.Microvascular endothelial function improves in patients who respond to antirheumatic therapy. These results support the importance of effective therapy for RA patients in terms of CV effects, which might extrapolate to reduced CV events in the future. Clinical trial registration no. ISRCTN57761809.

scholarly journals Endothelial damage and circadian blood pressure profile in rheumatoid arthritis

2019 ◽  
Vol 91 (5) ◽  
pp. 89-95 ◽  
Author(s):  
N P Shilkina ◽  
I E Yunonin ◽  
S V Butusova ◽  
E V Mikhailova ◽  
A A Vinogradov
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Dysfunction ◽  
Arterial Pressure ◽  
Pressure Profile ◽  
Endothelial Damage ◽  
Control Group ◽  
Endothelial Adhesion Molecule ◽  
Daily Monitoring ◽  
Immunoenzyme Analysis ◽  
Positive Correlations

Aim. To study the influence of the state of endothelium on the daily profile of arterial pressure (AP) in patients with rheumatoid arthritis (RA). Materials and methods. In 70 RA pts carried out C-reactive protein (CRP), vascular endothelial adhesion molecule type 1 (sVCAM-1), antigen von Willebrand Factor (AG WF), interleukin-8 (Il-8), rheumatoid factor (RF), IgG, endotheline-1 (ET-1), number of desquamated endotheliocytes cells (DE), VS, activity of renin by immunoenzyme analysis. The dysfunction of endothelium was evaluated by calculation of DE. The functional methods included the daily monitoring of arterial pressure (AP). Results. Arterial hypertension (AH) occurred in 40 (57.1%) pts. RA pts are revealed the signs of endothelial dysfunction, about which significant differences among the indices of activation of endothelium in comparison with control group testify. ET-1, sVCAM-1, vWF AG, Il-8, CRP content was higher in RA pts. Reliably above there was a number of DE. Reliable differences according to these indices depending of RA activity were discovered. With conducting of correlation analysis it is revealed, that markers of the activation of endothelium: sVCAM-1, vWF AG positively correlated with increasing RF IgG and indices of the immune inflammation: CRP, and DE number. In patients suffering from RA, showed signs of endothelial dysfunction. The positive correlation between endothelial damage and daily profile of AP show the relationship of these processes. Conclusion. Positive correlations between the damage of endothelium and disturbance of AP daily profile testify about the interrelation of these processes.

scholarly journals A prospective, longitudinal monocentric study on laser Doppler imaging of microcirculation: comparison with macrovascular pathophysiology and effect of adalimumab treatment in early rheumatoid arthritis

2019 ◽  
Vol 40 (3) ◽  
pp. 415-424 ◽  
Author(s):  
László Dávida ◽  
Vanda Pongrácz ◽  
Emir Awad Mohamed ◽  
Szilvia Szamosi ◽  
Gabriella Szücs ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Dysfunction ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Laser Doppler ◽  
Doppler Imaging ◽  
Early Ra ◽  
Adalimumab Therapy ◽  
Adalimumab Treatment ◽  
Prospective Longitudinal

AbstractIncreased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA). Tumour necrosis factor α (TNF-α) inhibitors may improve vascular function. In the first part of this study, we determined microcirculation during postoocclusive reactive hyperemia (PORH) representing endothelial function. In a nonselected population (n = 46) we measured flow-mediated vasodilation (FMD) of the brachial artery and laser Doppler flow (LDF) by ultrasound. Among LDF parameters, we determined TH1 (time to half before hyperemia), TH2 (time to half after hyperemia), Tmax (time to maximum) and total hyperemic area (AH). We measured von Willebrand antigen (vWF:Ag) by ELISA. In the second part of the study, we assessed the effects of adalimumab treatment on microcirculatory parameters in 8 early RA patients at 0, 2, 4, 8 and 12 weeks. We found significant positive correlations between FMD and LDF Tmax (R = 0.456, p = 0.002), FMD and TH2 (R = 0.435, p = 0.004), and negative correlation between vWF:Ag and Tmax (R = − 0.4, p = 0.009) and between vWF:Ag and TH2 (R = − 0.446, p = 0.003). Upon adalimumab therapy in early RA, TH2 times improved in comparison to baseline (TH2baseline = 26.9 s vs. TH24weeks = 34.7 s, p = 0,032), and this effect prolonged until the end of treatment (TH28weeks = 40.5, p = 0.026; TH212weeks = 32.1, p = 0.013). After 8 weeks of treatment, significant improvement was found in AHa (AHbaseline = 1599 Perfusion Units [PU] vs. AH8weeks = 2724 PU, p = 0.045). The PORH test carried out with LDF is a sensitive option to measure endothelial dysfunction. TH1 and TH2 may be acceptable and reproducible markers. In our pilot study, treatment with adalimumab exerted favorable effects on disease activity, endothelial dysfunction and microcirculation in early RA patients.

scholarly journals Investigation of prolactin-related vasoinhibin in sera from patients with diabetic retinopathy

2009 ◽  
Vol 161 (2) ◽  
pp. 345-353 ◽  
Author(s):  
Jakob Triebel ◽  
Michael Huefner ◽  
Giuliano Ramadori
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vascular Function ◽  
Control Group ◽  
Case Group ◽  
Serum Samples ◽  
Significant Difference ◽  
Patients With Diabetes

ObjectiveIn vitro experiments and in vivo studies on rodents demonstrate that N-terminal 14, 15, 16, 17, and 18 kDa fragments prolactin-related vasoinhibin (PRL-V) of human PRL are natural inhibitors of neovascularization in the retina and elsewhere. These N-terminal PRL fragments belong to a family of peptides named vasoinhibins, which act as endogenous regulators of angiogenesis and vascular function. These observations led to the hypothesis that PRL-V could play a role in the pathophysiology of diabetic retinopathy in humans. The purpose of this study was to investigate whether patients with diabetes mellitus and diabetic retinopathy have aberrant concentrations of PRL-V in the circulating blood.Research designWe performed a case–control study and developed a new technique to semi-quantitatively determine PRL-V in serum samples from 48 male subjects. The case group consisted of 21 patients with diabetes mellitus and proliferative or non-proliferative diabetic retinopathy. The control group consisted of 27 healthy subjects with no history of diabetes mellitus.MethodsFor the detection of PRL-V, we developed a new analytical method, consisting of immunologic and laser-induced fluorescence techniques.ResultsThe case group had significantly lower PRL-V serum concentrations than the control group (P=0.041). There was no significant difference between patients with proliferative and those with non-proliferative diabetic retinopathy.ConclusionWe conclude that given the antiangiogenic and antivasopermeability actions of PRL-V, the decreased serum levels of PRL-V in patients with diabetes mellitus could contribute to the development and progression of diabetic retinopathy.

2,3,7,8-TCDD exposure, endothelial dysfunction and impaired microvascular reactivity

2007 ◽  
Vol 26 (9) ◽  
pp. 705-713 ◽  
Author(s):  
Daniela Pelclová ◽  
Martin Prázný ◽  
Jan Škrha ◽  
Zdenka Fenclová ◽  
Marta Kalousová ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Control Group ◽  
Sod Activity ◽  
Microvascular Reactivity ◽  
Laser Doppler Perfusion Monitoring ◽  
High Level ◽  
Extended Group

Vascular function was examined in subjects with long-term high level of serum 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD) during their follow-up visits. Their earlier mean peak TCDD level at the time of exposure in 1965—1968 was estimated in the range of 3300—74 000 pg/g lipids. Ten former pesticide production workers heavily exposed to TCDD (age 57 ± 2 years, TCDD about 170 pg/g lipids) were examined in 2001. Extended group of 15 TCDD-exposed men (age 59 ± 3 years, TCDD about 130 pg/g lipids) underwent the same examination in 2004. Findings were compared with a control group of 14 healthy men (age 54 ± 2 years). Skin microvascular reactivity (MVR) was measured by laser Doppler perfusion monitoring in the forearm during post-occlusive reactive hyperemia (PORH) and thermal hyperemia (TH). Several parameters of MVR in men exposed to TCDD were significantly impaired, compared with the control group and further progression of the impairment of MVR has been observed between years 2001 and 2004. Serum concentration of E-selectin and inhibitor of tissue plasminogen activator 1 (PAI-1) was significantly higher in exposed subjects (56.0 ± 18.4 ng/mL versus 40.0 ± 12.0 ng/mL, P = 0.022 and 90.9 ± 33.3 ng/mL versus 45.0 ± 18.0, P = 0.002, respectively). In addition, PORH in the forearm was significantly negatively associated with SOD activity (r = —0.77, P = 0.009) as well as the velocity of perfusion increase during TH (r = —0.68, P = 0.03) and TH% (r = —0.78, P = 0.008). Our data document the presence of endothelial dysfunction in TCDD-exposed men. Human & Experimental Toxicology (2007) 26, 705— 713

P4433Equal cardiovascular risk in patients with diabetes mellitus versus rheumatoid arthritis?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B B Loegstrup ◽  
T Ellingsen ◽  
A B Pedersen ◽  
B Darvalics ◽  
H E Botker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Relative Risk ◽  
General Population ◽  
Coronary Revascularization ◽  
Control Group ◽  
Individual Record ◽  
Patients With Diabetes

Abstract Purpose To examine whether the risk of cardiovascular disease (heart failure (HF), ischemic heart disease (IHD), myocardial infarction (MI), and coronary revascularization) in patients with rheumatoid arthritis (RA) is comparable to the risk in patients with diabetes mellitus (DM) and general population. Methods The study included the entire Danish population encompassing about 5.7 million inhabitants. Through individual record linkage of nationwide administrative health registries, the authors identified subjects who developed RA and DM and compared these to a matched general population. The cohorts were followed from 1 January 1995 until December 2016. Results The study population consisted of a cohort of 15,491 RA patients, 309,698 DM patients, and a general population cohort of 77,455 subjects matched by age, sex, and year of diagnosis with the RA cohort. Cumulative incidence for HF, IHD, MI, PCI (percutaneous coronary intervention) and CABG (coronary artery bypass grafting) are shown in figure 1. The adjusted hazard ratio (HR) for diagnosis of HF within the 10-year observational period for RA (1.46; 95% CI 1.34–1.59) and DM (1.86; 95% CI 1.78–1.95) were increased compared to the general population. Comparing the risk of HF within the follow-up period a 21% relative risk (HR 0.79, 95% CI 0.73–0.85) reduction of HF in RA compared to DM patients was observed. The HR for IHD development during the follow-up period for RA (1.36; 95% CI 1.25–1.48) and DM (1.64; 95% CI 1.58–1.72) were increased compared to control group. Comparing the risk of IHD within the follow-up period a 17% relative risk (HR 0.83, 95% CI 0.77–0.89) reduction for IHD development in RA compared to DM patients. The HR for MI was increased both in RA (1.48; 95% CI 1.34–1.63) and DM (1.57; 95% CI 1.49–1.65) compared to the control group, without any statistical difference within RA and DM. According to the coronary revascularization, comparable increased numbers of PCI were observed in RA (1.37; 95% CI 1.22–1.54) and DM (1.50; 95% CI 1.41–1.59) patients compared to control subjects. Interestingly, the HR of coronary by-pass grafting (CABG) for RA (1.20; 95% CI 0.98–1.49) and DM (1.99; 95% CI 1.80–2.19) resulting in an adjusted 39% relative risk (0.61 95% CI 0.50–0.74) reduction for CABG in RA compared to DM patients. Figure 1 Conclusions Patients with RA are at increased risk of cardiovascular disease when compared to the general population although slightly lower than observed among patients with DM. Revascularization with CABG was only increased among DM patients, which likely reflects physician compliance to guidelines recommending CABG in case of multivessel disease among DM patients. Patients with RA should be considered for prophylactic strategies in the same way as recommended for patients with DM.

Sign in / Sign up

Export Citation Format

Share Document