scholarly journals Dynamics of traditional modifiable risk factors, total cardiovascular risk, and structural changes of carotid arteries in patients with rheumatoid arthritis on long-term interleukin-6 receptor antagonist treatment

2021 ◽  
Vol 59 (1) ◽  
pp. 84-92
Author(s):  
E. V. Gerasimova ◽  
T. V. Popkova ◽  
A. V. Martynova ◽  
I. G. Kirillova ◽  
E. I. Markelova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Interleukin 6 ◽  
Structural Changes ◽  
Carotid Arteries ◽  
Atherogenic Index ◽  
Modifiable Risk Factors ◽  
Traditional Risk Factors ◽  
Very High

The effect of an inhibitor of interleukin-6 (IL-6) receptors on the state of the cardiovascular system in patients with rheumatoid arthritis remains poorly understood.Objective: to study the effect of therapy with an inhibitor of IL-6 receptors, tocilizumab (TCZ), on the dynamics of modifiable risk factors, total cardiovascular risk, and structural changes in the carotid arteries in patients with rheumatoid arthritis during a 12-month follow-up period.Material and methods. The study included 40 patients with active rheumatoid arthritis (33 women and 7 men) with ineffectiveness and/or intolerance to basic anti-inflammatory drugs (DMARDs); the median age was 55 (49; 64) years, the duration of the disease – 102 (48; 162) months; DAS28 – 6.2 (5.5; 6.7) points; all patients were seropositive for rheumatoid factor, 80% – for antibodies to cyclic citrullinated peptide. Patients received TCZ 8 mg/kg therapy every 4 weeks: 52% received TCZ monotherapy, 48% received combined TCZ therapy with DMARDs. All patients underwent an assessment of traditional risk factors, the total cardiovascular risk was calculated using the mSCORE, and atherosclerotic vascular damage was assessed by the detection of atherosclerotic plaques.Results. After 12 months of TCZ therapy, a decrease in disease activity was noted: remission was observed in 25 patients (64%) with rheumatoid arthritis, low disease activity – in 12 (31%); DAS28, HAQ, CRP and ESR concentrations decreased significantly. А high frequency of traditional risk factors was found in rheumatoid arthritis patients: dyslipidemia – 67%, arterial hypertension – 65%, overweight – 55%, burdened heredity for cardiovascular diseases (CVD) – 35%, smoking – 15%. Every third patient had a combination of three or more traditional risk factors. After 12 months of TCZ therapy, the frequency of traditional risk factors did not significantly change, there was an increase in BMI by 2%, an increase in the concentration of HDL-C in serum by 27%, a decrease in the atherogenic index by 28% (p<0.01). Moreover, an increase in the level of HDL-C by the finish was found in patients regardless of statin therapy. Changes in the concentration of other lipids during the observation, including during therapy with statins, were not observed. A negative correlation the dynamics of the levels of ∆HS and ∆CRP (R=−0.37; p<0.05), ∆HS of LDL and ∆CRP (R=−0.42; p<0.01) was found. A very high cardiovascular risk according to the SCORE scale was determined in 78% of patients, moderate – in 2%, and low – in 20% of patients. The distribution of patients by mSCORE value and level of cardiovascular risk were not documented after 12 months of TCZ therapy. No significant structural changes in carotid arteries in rheumatoid arthritis patients were revealed by the end of 12 months of TCZ therapy.Conclusion. After 12 months of TCZ therapy resulted in decreased rheumatoid arthritis activity, increased the level of HDL-C, atherogenic index, BMI; the frequency of traditional risk factors and the total cardiovascular risk did not change. Despite the very high risk of developing CVD associated with the inflammatory activity of rheumatoid arthritis, the accumulation of traditional risk factors and their combination, subclinical atherosclerotic vascular lesions, no significant structural changes in the carotid arteries were found in rheumatoid arthritis patients on TCZ therapy. Insufficient effectiveness of statin therapy was revealed.

scholarly journals Cardiovascular risk in rheumatoid arthritis.

2018 ◽  
Vol 96 (6) ◽  
pp. 491-497
Author(s):  
V. O. Omelchenko ◽  
M. A. Korolev ◽  
T. I. Pospelova ◽  
V. I. Konenkov
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Autoimmune Diseases ◽  
High Mortality ◽  
Literature Search ◽  
Web Of Science ◽  
Main Factors ◽  
Traditional Risk Factors ◽  
The Individual

The problem of high mortality in patients with rheumatoid arthritis, one of the most common autoimmune diseases, is still unsolved. Many studies have shown a significant impact on cardiovascular risk of both traditional and non-traditional risk factors (genetic, RA-associated etc). To improve the individual prognosis, team actions by physicians of different specialties are necessary on the basis of good awareness and patients ’ compliance. The aim of the review was to characterize the main factors involved in the formation of cardiovascular risk and give a notion about the features of its assessing in patients with rheumatoid arthritis. Literature search was carried out using Scopus, Web of Science, RSCI by keywords.

scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: A Systematic Literature Review in Latin America

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Juan Camilo Sarmiento-Monroy ◽  
Jenny Amaya-Amaya ◽  
Juan Sebastián Espinosa-Serna ◽  
Catalina Herrera-Díaz ◽  
Juan-Manuel Anaya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Literature Review ◽  
Cardiovascular Risk Factors ◽  
Systematic Literature Review ◽  
Long Duration ◽  
Major Predictor ◽  
Traditional Risk Factors

Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify “nontraditional” risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates.

scholarly journals Cardiovascular Risk in Rheumatoid Arthritis

2021 ◽  
Author(s):  
Alexandru Caraba ◽  
Flavia Corina Babalic ◽  
Andreea Munteanu ◽  
Otilia Tomulescu
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Inflammatory Rheumatic Diseases ◽  
Atherosclerotic Cardiovascular Disease ◽  
Eular Recommendations ◽  
Related Risk ◽  
Traditional Risk Factors ◽  
Artery Disease

Rheumatoid arthritis (RA), one of the most common inflammatory rheumatic diseases. It is defined as a chronic destructive and deforming arthropathy; it also finds its expression through systemic manifestations. RA has an undulating evolution, with remissions and relapses. Atherosclerotic cardiovascular disease represents one of the most common extra-articular manifestations of RA. It is known that the cardiovascular (CV) morbidity and mortality represent one of the leading causes of reduced life expectancy in RA. Patients with RA develop a premature and accelerated atherosclerosis, explaining the high incidence and prevalence of angina, myocardial infarction, congestive heart failure, stroke, peripheral artery disease, and the need for revascularization. Traditional risk factors (arterial hypertension, obesity, smoking, dyslipidemia, insulin resistance and metabolic syndrome, diabetes mellitus, male gender, physical inactivity) interplay with RA-related risk factors, generating endothelial dysfunction, arterial stiffness, carotid plaque, and atherosclerosis. Traditional cardiovascular risk factors alone cannot explain the increased incidence of premature and accelerated atherogenesis. Chronic inflammation, hyperhomocysteinemia, and hypercoagulation act as novel cardiovascular risk factors. Rheumatoid inflammation exerts direct effects on vessels, or by means of altered traditional risk factors. Antirheumatic drugs may promote atherogenesis or by reducing systemic inflammation may decrease cardiovascular risk. EULAR recommendations require annual cardiovascular risk assessment.

scholarly journals The types of left ventricular remodeling in patients with rheumatoid arthritis

2020 ◽  
Vol 14 (2) ◽  
pp. 62-68
Author(s):  
I. A. Krivotulova ◽  
K. V. Korochina ◽  
T. V. Chernysheva ◽  
G. E. Kuznetsov ◽  
L. R. Tenchurina
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Drug Therapy ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Patient Age ◽  
Patient Âgé ◽  
Lv Remodeling ◽  
Traditional Risk Factors

Studying the factors leading to a pathological change in the cardiac structure in patients with rheumatoid arthritis (RA) can contribute to improvement in early diagnosis and to prevention of premature mortality from cardiovascular events.Objective. To study the types of left ventricular (LV) remodeling in patients with RA, by taking into account traditional cardiovascular risk factors, and to assess the clinical and immunological features of RA and the impact of drug therapy.Patients and methods. The investigation enrolled 74 RA patients who underwent assessment of echocardiography findings, by determining the type of LV remodeling, traditional cardiovascular risk factors, clinical and immunological features of the disease, as well as the current drug therapy.Results and discussion. Eccentric LV hypertrophy (ELVH) (n=33 (44.59%)) and concentric LV hypertrophy (CLVH) (n=34 (45.95%)) occurred at almost the same frequency among the pathological types of LV remodeling in patients with RA. Higher DAS28 values (p<0.0001) were noted in ELVH than in CLVH. There were also positive correlations of EHLH with ESR and CRP level (r= 0.51, p<0.0001; r=0.48, p=0.0001, respectively). The higher values of systolic blood pressure (p=0.0002), body mass index (p=0.01), patient age (p=0.0001), and the incidence of dyslipidemia (p= 0.008) were established in CVLH than in ELVH. LV diastolic dysfunction (DD) was detected much more frequently in RA patients with CLVH than in those with ELVH (p=0.01). The DD parameters (peak A, E/A) correlated with the degree (r=0.5, p<0.0001; r=-0.5. p<0.0001) and stage of hypertension (r=0.54, p<0.0001; r=-0.48, p=0.0001, respectively), as well as with peak A and traditional risk factors, such as patient age (r=0.52, p<0.0001), and high-density lipoprotein cholesterol levels (r=-0.48, p=0.0001).Conclusion. Most patients with RA had signs of LV hypertrophy; moreover, ELVH was closely linked with disease activity, whereas CLVH was related to the traditional risk factors.

Structural changes in the heart and carotid arteries in hypertensive patients associated with cardiovascular risk factors

1997 ◽  
Vol 4 (4) ◽  
pp. 283-289 ◽  
Author(s):  
Eugenia Marchesi ◽  
Renata Baiardini ◽  
Paolo Centeleghe ◽  
Donatella Covini ◽  
Arturo Frattoni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Structural Changes ◽  
Carotid Arteries ◽  
Hypertensive Patients

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.

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