Systemic inflammation and cardiovascular risk factors predict rapid progression of atherosclerosis in rheumatoid arthritis

Autor: Joseph F. Polak, John M. Erikson, Daniel H. O'Leary, Inmaculada del Rincón, José Félix Restrepo, Emily Molina, Daniel F. Battafarano, Agustín Escalante
Rok vydání: 2014
Předmět:
Carotid Artery Diseases
Male
Systemic inflammation
Carotid Intima-Media Thickness
Gastroenterology
Arthritis
Rheumatoid
Risk Factors
Immunology and Allergy
Longitudinal Studies
medicine.diagnostic_test
Anticholesteremic Agents
Smoking
Middle Aged
Connective tissue disease
Carotid Arteries
Cardiovascular Diseases
Antirheumatic Agents
Rheumatoid arthritis
Erythrocyte sedimentation rate
Hypertension
Disease Progression
Female
medicine.symptom
medicine.medical_specialty
Hypercholesterolemia
Immunology
Inflammation
Blood Sedimentation
Peptides
Cyclic
Article
General Biochemistry
Genetics and Molecular Biology
Rheumatology
Rheumatoid Factor
Internal medicine
Diabetes mellitus
Diabetes Mellitus
medicine
Humans
Hypoglycemic Agents
Rheumatoid factor
Obesity
Risk factor
Antihypertensive Agents
Aged
business.industry
Atherosclerosis
medicine.disease
business
HLA-DRB1 Chains
Zdroj: Annals of the Rheumatic Diseases. 74:1118-1123
ISSN: 1468-2060
0003-4967
Popis: ObjectiveTo estimate atherosclerosis progression and identify influencing factors in rheumatoid arthritis (RA).MethodsWe used carotid ultrasound to measure intima-media thickness (IMT) in RA patients, and ascertained cardiovascular (CV) risk factors, inflammation markers and medications. A second ultrasound was performed approximately 3 years later. We calculated the progression rate by subtracting the baseline from the follow-up IMT, divided by the time between the two scans. We used logistic regression to identify baseline factors predictive of rapid progression. We tested for interactions of erythrocyte sedimentation rate (ESR) with CV risk factors and medication use.ResultsResults were available for 487 RA patients. The mean (SD) common carotid IMT at baseline was 0.571 mm (0.151). After a mean of 2.8 years, the IMT increased by 0.050 mm (0.055), p≤0.001, a progression rate of 0.018 mm/year (95% CI 0.016 to 0.020). Baseline factors associated with rapid progression included the number of CV risk factors (OR 1.27 per risk factor, 95% CI 1.01 to 1.61), and the ESR (OR 1.12 per 10 mm/h, 95% CI 1.02 to 1.23). The ESR×CV risk factor and ESR×medication product terms were significant, suggesting these variables modify the association between the ESR and IMT progression.ConclusionsSystemic inflammation and CV risk factors were associated with rapid IMT progression. CV risk factors may modify the role of systemic inflammation in determining IMT progression over time. Methotrexate and antitumour necrosis factor agents may influence IMT progression by reducing the effect of the systemic inflammation on the IMT.
Databáze: OpenAIRE
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