Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome.

Autor: Burggraaf B; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands. Electronic address: b.burggraaf@franciscus.nl., van Breukelen-van der Stoep DF; Department of Rheumatology, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands; Department of Rheumatology, Ziekenhuis Gelderse Vallei, Willy Brandtlaan 10, 6716, RP, Ede, The Netherlands., de Vries MA; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., Klop B; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., van Zeben J; Department of Rheumatology, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., van de Geijn GM; Department of Clinical Chemistry, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., van der Meulen N; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., Birnie E; Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., Prinzen L; Department of Clinical Chemistry, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands., Castro Cabezas M; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2018 Apr; Vol. 271, pp. 84-91. Date of Electronic Publication: 2018 Feb 17.
DOI: 10.1016/j.atherosclerosis.2018.02.019
Abstrakt: Background and Aims: Rheumatoid arthritis (RA) has been associated with an increased risk of atherosclerosis. We aimed to evaluate the progression of carotid intima media thickness (cIMT) in RA patients subject to a cardiovascular treat-to-target intervention. In addition, the presence of the metabolic syndrome (MetS) on cIMT outcomes was evaluated.
Methods: We performed a cohort analysis of FRANCIS, in which RA patients ≤70 years without CVD or diabetes mellitus were randomized for either a treat-to-target intervention or usual care concerning CVD risk factors. MetS was scored at baseline.
Results: Three-year data was available in 212 well-controlled RA patients. The treat-to-target intervention resulted in a lower cIMT progression over three years compared to the usual care. However, there was no difference in cIMT at three years between groups. MetS was present in 40.1% of RA patients. Baseline cIMT was significantly higher in RA patients with MetS compared to those without (0.619 (0.112) versus 0.557 (0.104) mm; p < 0.001). After three years, cIMT progression was comparable (0.043 (0.071) versus 0.043 (0.072) mm; p = 0.96). In RA patients with MetS, the presence of plaques increased over three years from 12.9% to 23.5% (p = 0.01). The type of intervention had no effect on cIMT progression in RA patients with MetS. However, in subjects without MetS, treat-to-target resulted in a lower progression.
Conclusions: RA patients with MetS showed an increased CVD risk profile based on both a higher prevalence of CVD risk factors and structural vascular changes. A treat-to-target approach of CVD risk factors reduced cIMT progression only in RA patients without MetS.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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