scholarly journals Vascular Involvement in Rheumatoid Arthritis

2020 ◽  
Author(s):  
Alexandru Caraba ◽  
Stela Iurciuc ◽  
Mircea Iurciuc
Keyword(s):  
Rheumatoid Arthritis ◽  
Vascular System ◽  
Carotid Artery Disease ◽  
Early Stage ◽  
Macrovascular Disease ◽  
Vascular Involvement ◽  
Inflammatory Rheumatic Diseases ◽  
Artery Disease ◽  
The One ◽  
Peripheral Arterial

Rheumatoid arthritis (RA) represents the one of the most common inflammatory rheumatic diseases, which generates disability and significantly reduces the quality of life. RA can affect the vascular system, in addition to joint involvement. Vascular involvement increases the morbidity and mortality among these patients. Macrovascular disease, related to accelerated atherosclerosis, has a high prevalence among RA patients, in the form of carotid artery disease, ischemic heart disease, and peripheral arterial obstructive disease. Microvascular disease, studied in recent years by means of nailfold capillaroscopy, is present even in the early stage of RA evolution. Rheumatoid vasculitis can occur in severe forms of RA.

scholarly journals Ischemic Heart Disease and Rheumatoid Arthritis—Two Conditions, the Same Background

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1042
Author(s):  
Elena Rezuș ◽  
Luana Andreea Macovei ◽  
Alexandra Maria Burlui ◽  
Anca Cardoneanu ◽  
Ciprian Rezuș
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Vascular Involvement ◽  
Inflammatory Rheumatic Diseases ◽  
Cvd Risk ◽  
Mortality And Morbidity ◽  
Traditional Risk Factors ◽  
Artery Disease

Rheumatoid arthritis (RA) is one of the most frequent inflammatory rheumatic diseases, having a considerably increased prevalence of mortality and morbidity due to cardiovascular disease (CVD). RA patients have an augmented risk for ischemic and non-ischemic heart disease. Increased cardiovascular (CV) risk is related to disease activity and chronic inflammation. Traditional risk factors and RA-related characteristics participate in vascular involvement, inducing subclinical changes in coronary microcirculation. RA is considered an independent risk factor for coronary artery disease (CAD). Endothelial dysfunction is a precocious marker of atherosclerosis (ATS). Pro-inflammatory cytokines (such as TNFα, IL-1, and IL-6) play an important role in synovial inflammation and ATS progression. Therefore, targeting inflammation is essential to controlling RA and preventing CVD. Present guidelines emphasize the importance of disease control, but studies show that RA- treatment has a different influence on CV risk. Based on the excessive risk for CV events in RA, permanent evaluation of CVD in these patients is critical. CVD risk calculators, designed for the general population, do not use RA-related predictive determinants; also, new scores that take into account RA-derived factors have restricted validity, with none of them encompassing imaging modalities or specific biomarkers involved in RA activity.

Prescription rate of anti-atherosclerotic drugs in German nursing homes and its impact on outcome

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 158-166
Author(s):  
Noemi Galas ◽  
Ingrid Becker ◽  
Tomasz Ficon ◽  
Maik Sakrauski ◽  
Rita Reichert ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Nursing Care ◽  
Arterial Disease ◽  
Care Homes ◽  
Artery Disease ◽  
One Year ◽  
The One ◽  
Peripheral Arterial

Abstract. Background: Peripheral arterial disease (PAD) is one of the major manifestations of general atherosclerosis and strongly associated with increased cardiovascular morbidity and mortality. Because only few epidemiologic studies are available concerning the prevalence of PAD in inhabitants ≥ 80 years of age, we screened inhabitants of nursing care homes in Germany for PAD and cardiovascular diseases and to assess the one year mortality. Patients and methods: We conducted a prospective cohort study, screening inhabitants of 42 nursing homes for PAD. Demographic data, comorbidities, cardiovascular risk factors and daily medication were collected. PAD was defined as ankle-brachial index < 0.9. During a follow up period of one year, cardio- and cerebrovascular events and mortality were recorded, as well as the rate of falls and major amputation. Results: 1,329 probands (391 men, 938 women) > 60 years were eligible for further analysis. The mean age was 84.1 years (range 61–107 years) and the prevalence of PAD was 31.5 % . Media sclerosis was found in up to 17 %, and an existing diagnosis of PAD (in case of pathological ABI) and undertreatment was common. Probands with PAD were less likely to be treated according to guideline recommendations (antiplatelet therapy, beta blockers, statins) than probands with coronary artery disease (CAD). The overall one-year mortality was 19.8 % (n = 236), significantly higher than for a gender and age matched German population (p < 0.001). Conclusions: The current study shows a high prevalence of PAD in German nursing care homes. The one year mortality was not significantly different between probands with PAD and those with severe PAD (defined as an ABI of ≤ 0.5), whereas a media sclerosis was associated with an increased risk in probands with CAD in comparison to those without. Use of anti-diabetic agents and aspirin in monotherapy was associated with a reduced one-year mortality risk. Keywords: Peripheral arterial disease, nursing care homes, coronary artery disease

Risk of peripheral arterial occlusive disease in patients with rheumatoid arthritis

2016 ◽  
Vol 115 (02) ◽  
pp. 439-445 ◽  
Author(s):  
Ya-Wen Chuang ◽  
Mei-Ching Yu ◽  
Cheng-Li Lin ◽  
Tung-Min Yu ◽  
Kuo-Hsiung Shu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Peripheral Arterial Occlusive Disease ◽  
Proportional Hazards Model ◽  
Early Stage ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Cox Proportional Hazards Model ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Peripheral Arterial

SummaryRheumatoid arthritis (RA) is associated with atherosclerosis. However, the relationship between RA and peripheral arterial occlusive disease (PAOD) remains unclear. We used a national health insurance database to identify a cohort of 30,812 patients diagnosed with RA between 2000 and 2011. Each RA patient was frequency-matched according to age and sex with a patient without RA from a control cohort. A multivariate Cox proportional hazards model was used to analyse the adjusted risk of PAOD. The incidence of PAOD was 1.73-fold higher (95 % confidence interval [CI] = 1.57–1.91) in the RA cohort than in the non-RA cohort. The adjusted risk of PAOD was the highest in the patients with RA aged ≤ 49 years (hazard ratio [HR] = 3.39, 95 % CI = 2.66–4.32). Patients with RA and various comorbidities showed a significantly higher risk of PAOD (HR = 9.62, 95 % CI = 4.86–19.1) compared with control patients without comorbidity. The risk of PAOD increased during the first year of follow-up. In conclusion, patients with RA have an independently higher risk of PAOD compared with the general population. Patients with RA and various comorbidities and those at a young age and early stage of the disease have an increased risk of PAOD.

scholarly journals Carotid artery disease and stroke in patients with peripheral arterial disease. The role of inflammation

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Giusy Sirico ◽  
Lucrezia Spadera ◽  
Mario De Laurentis ◽  
Gregorio Brevetti
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Peripheral Arterial Disease ◽  
Carotid Artery Disease ◽  
Arterial Disease ◽  
Carotid Plaques ◽  
Markers Of Inflammation ◽  
Artery Disease ◽  
Peripheral Arterial

Although during the last decade there have been great advances in our knowledge of the epidemiology and pathophysiology of multi-district atherosclerotic disease, little is known about the association between peripheral arterial disease and carotid artery disease. This review was conceived to cast some light on this topic, paying special attention to inflammation which plays a pivotal role in atherosclerosis. An aspect of pathophysiologic and clinical relevance is that the coexistence of carotid disease is more frequent in peripheral arterial disease than in coronary artery disease, not only in terms of carotid stenosis, but also with respect to the presence of hypoechoic unstable plaque. These latter plaques present a large infiltration of macrophages and are associated to high levels of inflammatory markers. In particular, the greater prevalence of hypoechoic carotid plaques in peripheral arterial disease compared to patients with carotid artery disease was poorly related to classic risk factors, but showed an independent association with an increased number of leukocyte and neutrophil cells, which are reliable markers of inflammation. The greater prevalence of hypoechoic unstable carotid plaques could explain why peripheral arterial disease portends higher risk of stroke than coronary artery disease.

Study of DNA polymorphisms of the apolipoprotein AI-CIII-AIV gene cluster in patients with peripheral arterial disease

1989 ◽  
Vol 76 (2) ◽  
pp. 221-228 ◽  
Author(s):  
M. V. Monsalve ◽  
R. Young ◽  
S. A. Wiseman ◽  
S. Dhamu ◽  
J. T. Powell ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Peripheral Arterial Disease ◽  
Gene Cluster ◽  
Apolipoprotein B ◽  
Carotid Artery Disease ◽  
Arterial Disease ◽  
Dna Polymorphisms ◽  
Apolipoprotein Ai ◽  
Artery Disease ◽  
Peripheral Arterial

1. We have determined the frequency of DNA polymorphisms of the human apolipoprotein AI-CIII-AIV gene cluster, detected with XmnI, PstI, and PvuII, in a group of patients with peripheral arterial disease. 2. Of the patients, 81 had no evidence of disease in the coronary and carotid arteries, 73 had coronary artery disease but no evidence of carotid artery disease, 25 patients had carotid artery disease but no evidence of coronary artery disease, and 38 had both coronary and carotid artery disease. 3. Levels of triacylglycerol, cholesterol, apolipoprotein B and apolipoprotein AI were not significantly different between the four patient groups. 4. The frequencies of the alleles for the apolipoprotein AI-CIII-AIV polymorphisms, detected with XmnI, PstI and PvuII, did not differ significantly in the patient groups when compared with a sample of clinically well normolipidaemic individuals also from a London population. 5. All five patients with the XmnI genotype we designate X2X2 had high levels of cholesterol, apolipoprotein B and apolipoprotein AI. 6. Patients with the rare VB2 allele of the apolipoprotein CIII-AIV restriction fragment length polymorphism had lower levels of cholesterol, acylglycerol and significantly lower levels of serum apolipoprotein. 7. Our observations suggest that variation in the apolipoprotein AI-CIII-AIV gene cluster may not be contributing significantly to the development of peripheral arterial disease, but variation associated with some of the restriction fragment length polymorphisms may be involved in determining levels of cholesterol- and apolipoprotein-B-containing lipoproteins.

scholarly journals Computed Tomography Angiography Evaluation of Peripheral Arterial Disease and Correlation with Colour Doppler

2020 ◽  
Vol 8 (2) ◽  
pp. 73-79
Author(s):  
M. Balaji Vara Prasad ◽  
Srinadh Boppana ◽  
Mounika Reddy ◽  
Nainika Juvvadi ◽  
Rajeshwari ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Computed Tomography Angiography ◽  
Vascular System ◽  
Early Stage ◽  
Signs And Symptoms ◽  
Arterial Disease ◽  
Colour Doppler ◽  
Peripheral Arterial ◽  
Sensitivity Specificity

Background: Peripheral Arterial Disease Is a Major Problem Among the Population of Those 55 Years and Older. MDCT is a Non-Invasive Method of Visualization of Vascular System. It Affords More Widespread Vascular Screening, Allowing Diagnosis to be Made at an Early Stage. The objective is to Assess the Role of Multidetector Computed Tomography Angiography in Peripheral Arterial Disease of Lower Extremities. Subjects & Methods: A Prospective Study of 35 Patients with Signs and Symptoms of PVD, Were Subjected to Colour Doppler Ultrasonography and MDCT Examination Between a Period of 1st August 2018 to 31st May 2019. Results: Our Study Shows a Very Good Sensitivity, Specificity, PPV, NPV and Accuracy of Doppler in Assessing the Soft Plaque (82%, 100%, 100%, 97%, 97% Respectively) & in Evaluation of Stenosis Like <50% Stenosis (100%, 99%, 85%, 100% & 99% Respectively), 50-99% Stenosis (100%, 99%, 96%. 100% & 99.8% Respectively), & Occlusion (84%, 100%. 100%, 98% & 98% Respectively). The Only Parameter Which Showed Poor Result Was in Evaluation of Calcified Plaque. Conclusion: Our Study Shows that Both Colour Doppler & MDCT Can Be Complimentary in Lower Limb Arterial Disease Evaluation.

scholarly journals Diagnosis of Peripheral Artery Disease using Cnn Classifier

2020 ◽  
Vol 8 (5) ◽  
pp. 5421-5425
Keyword(s):  
Peripheral Arterial Disease ◽  
Peripheral Artery Disease ◽  
Early Stage ◽  
Arterial Disease ◽  
Input Image ◽  
The Body ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Peripheral Arterial ◽  
Specific Symptoms

Peripheral Arterial Disease is common to all elderly peoples, which reduces the blood flow to the limbs. Due to PAD, the affected person unable to walk and gives pain while they try to walk. This PAD does not have any specific symptoms to affected persons in the earlier stage. This paper presents a solution to find the disease in which stage the person was affected. The Peripheral arterial disease is evaluated using convolution neural network classifier to identify in early stage to take treatments. The affected persons image (particular part of the body. Eg. Leg) is compared with the dataset. The dataset contains the collection of images that contains both normal and Peripheral arterial disease affected images. The CNN classifier compares with the dataset and shows that the given input image is in normal stage or it is affected by the Peripheral Artery disease. The accuracy level is high. This methodology helps to find the disease in earlier stage

Is peripheral arterial disease associated with carotid artery disease in Egyptians? A pilot study

2016 ◽  
Vol 53 (1) ◽  
pp. 12
Author(s):  
Ahmed Sayed ◽  
SandraM Ahmed ◽  
AhmedM Abdelalim ◽  
Martin Nagah ◽  
Hussein Khairy
Keyword(s):  
Pilot Study ◽  
Carotid Artery ◽  
Peripheral Arterial Disease ◽  
Carotid Artery Disease ◽  
Arterial Disease ◽  
Artery Disease ◽  
Peripheral Arterial

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.

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