The Extent of Subclinical Atherosclerosis Is Partially Predicted by the Inflammatory Load: A Prospective Study over 5 Years in Patients with Rheumatoid Arthritis and Matched Controls
Autor: | Anna Södergren, Christine Bengtsson, Bozena Möller, Kjell Karp, Solbritt Rantapää-Dahlqvist, Solveig Wållberg-Jonsson |
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Rok vydání: | 2015 |
Předmět: |
Adult
Carotid Artery Diseases Male medicine.medical_specialty Immunology Inflammation Blood Sedimentation Disease Carotid Intima-Media Thickness Severity of Illness Index Statistics Nonparametric Arthritis Rheumatoid Rheumatology Predictive Value of Tests Internal medicine Severity of illness Humans Immunology and Allergy Medicine Prospective Studies Prospective cohort study Sweden biology business.industry C-reactive protein Case-control study Middle Aged Atherosclerosis Prognosis medicine.disease C-Reactive Protein Cardiovascular Diseases Area Under Curve Case-Control Studies Rheumatoid arthritis Predictive value of tests Multivariate Analysis Disease Progression Linear Models biology.protein Female Inflammation Mediators medicine.symptom business |
Zdroj: | The Journal of Rheumatology. 42:935-942 |
ISSN: | 1499-2752 0315-162X |
Popis: | Objective.This prospective followup study investigated subclinical atherosclerosis in relation to traditional cardiovascular disease (CVD) risk factors and inflammation in patients with rheumatoid arthritis (RA) recruited at diagnosis compared with controls.Methods.Patients diagnosed with early RA were consecutively recruited into a prospective study. From these, a subgroup aged ≤ 60 years (n = 71) was consecutively included for ultrasound measurement of intima-media thickness (IMT) and flow-mediated dilation (FMD) at inclusion (T0) and after 5 years (T5). Age- and sex-matched controls (n = 40) were also included.Results.In the Wilcoxon signed-rank test, both IMT and FMD were significantly aggravated at T5 compared to baseline in patients with RA, whereas only IMT was significantly increased in controls. In univariate linear regression analyses among patients with RA, the IMT at T5 was significantly associated with age, systolic blood pressure (BP), cholesterol, triglycerides, Systematic Coronary Risk Evaluation (SCORE), and Reynolds Risk Score at baseline (p < 0.05). Similarly, FMD at T5 was significantly inversely associated with age, smoking, systolic BP, SCORE, and Reynolds Risk Score (p < 0.05). A model with standardized predictive value from multiple linear regression models including age, smoking, BP, and blood lipids at baseline significantly predicted the observed value of IMT after 5 years. When also including the area under the curve for the 28-joint Disease Activity Score over 5 years, the observed value of IMT was predicted to a large extent.Conclusion.This prospective study identified an increased subclinical atherosclerosis in patients with RA. In the patients with RA, several traditional CVD risk factors at baseline significantly predicted the extent of subclinical atherosclerosis 5 years later. The inflammatory load over time augmented this prediction. |
Databáze: | OpenAIRE |
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