The aim: To determine changes in endothelial dysfunction and immunological response in patients with rheumatoid arthritis with and without coronary heart disease. Materials and methods: The study involved 151 patients with RA and coronary heart disease. The ED was assessed by examining the NO system in RA for determination of the content in the blood of the product of NO synthase – the final metabolites of NO2– and NO3– and the level of VEGF and CD28 in the serum. Results: The results of the study of the levels of metabolites NO2– and NO3– in the first and second groups showed their increased content. Analysis of the content of VEGF in the blood for patients with different durations of the disease showed that the concentration of the studied protein grows larger with increasing duration of the disease. The maximum of sCD28 concentration was found in middle-aged patients, and the minimum (the difference was significant) – in the elderly. Conclusions: As the duration of the disease increases, the content of VEGF in the blood of patients increases, which, at the same time, did not show age dependence on RA and did not change further with concomitant coronary heart disease. Detected concentrations of sCD28 are higher in patients with less prolonged RA, and begin to decrease with increasing duration of the disease.

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