Cardiovascular risk assessment with carotid ultrasound in rheumatoid arthritis

Mazarío, Roxana González; Gil, J. J. Fragío; Calabuig, P. Martinez; García, Elena Grau; Martínez, Antonio José Cañada; Ivorra, José Andrés Román

doi:10.1016/j.medcli.2022.01.017

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…As expected, a link between cIMT and DAS-28 was also detected by Ambrosino et al [ 142 ]. Similar results have also been identified by Wah-Suarez et al [ 143 ], as well as by Gonzales Mazario et al [ 144 ] who, additionally, correlated cIMT with disease duration. Furthermore, it has been demonstrated that RA patients with carotid atherosclerotic plaques sustain a higher risk of acute cardiovascular events and cardiovascular mortality.…”

Section: Assessing Cardiovascular Risk In Rasupporting

confidence: 89%

Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy

Popescu

Rezuş

Bădescu

et al. 2023

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Rheumatoid arthritis (RA), one of the most common of the chronic inflammatory autoimmune diseases (CIADs), is recognized as an independent cardiovascular risk factor. Traditional risk factors such as smoking, arterial hypertension, dyslipidemia, insulin resistance, and obesity are frequently found in RA. Given the increased risk of mortality and morbidity associated with cardiovascular disease (CVD) in RA patients, screening for risk factors is important. Moreover, there is a need to identify potential predictors of subclinical atherosclerosis. Recent studies have shown that markers such as serum homocysteine, asymmetric dimethylarginine, or carotid intima–media thickness (cIMT) are correlated with cardiovascular risk. Although RA presents a cardiovascular risk comparable to that of diabetes, it is not managed as well in terms of acute cardiovascular events. The introduction of biological therapy has opened new perspectives in the understanding of this pathology, confirming the involvement and importance of the inflammatory markers, cytokines, and the immune system. In addition to effects in inducing remission and slowing disease progression, most biologics have demonstrated efficacy in reducing the risk of major cardiovascular events. Some studies have also been conducted in patients without RA, with similar results. However, early detection of atherosclerosis and the use of targeted therapies are the cornerstone for reducing cardiovascular risk in RA patients.

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Section: Assessing Cardiovascular Risk In Rasupporting

confidence: 89%

Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy

Popescu

Rezuş

Bădescu

et al. 2023

Life

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“…It has been considered as a reliable outcome measure in clinical trials regarding the effectiveness of lipid-lowering therapy in the reduction of cardiovascular risk assessed with the utilization of cIMT [ 23 ]. This assessment is frequently performed in adults diagnosed with RA, who tend to develop atherosclerosis at a younger age than their healthy counterparts and therefore have higher cIMT values [ 24 , 25 ]. Nevertheless, there are conflicting data regarding the utilization of cIMT in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre Experience with Carotid Intima-Media Measurements

et al. 2023

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Background: Children diagnosed with juvenile idiopathic arthritis (JIA) are thought to be more likely to develop cardiovascular disease in adulthood. The factors modulating the cardiovascular risk, involving exposure to secondhand smoking, sedentary lifestyle and abnormal body mass index, might have had a stronger impact during the COVID-19 pandemic. The lack of reliable prognostic markers for a higher probability of cardiovascular events might be solved by carotid intima-media thickness (cIMT) measurement. The paramount goal of the study was to assess its usefulness in JIA patients. Materials and Methods: The results of cIMT measured by a single physician in 45 children diagnosed with JIA were compared to 37 age- and sex-matched healthy counterparts. The analysis also involved anthropometric parameters, laboratory tests, and a survey regarding lifestyle-related factors. Results: Four JIA patients appeared to have cIMT above the 94th percentile. A positive correlation between erythrocytes sedimentation rate (ESR) and right carotid artery percentiles was found. Passive smoking increased the cardiovascular risk regardless of JIA. Doubling the daily screen time during the pandemic led to a significant reduction in children’s physical activity. However, the number of enrolled subjects was not enough to make significant recommendations. Conclusions: cIMT measurements remain an interesting perspective for future cardiovascular screening of children with JIA. It has yet to be determined whether it should be considered in all JIA patients on a reliable basis.

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“…It is one of the most well validated methods for CVD risk assessment, which predicts the onset of atherogenesis and thus the occurrence of future cardiovascular events in the general population [ 26 ]. Meta-analyses available in the literature conclude that RA patients have accelerated atherosclerosis and increased IMT compared to healthy subjects [ 27 , 28 ]. A positive association between active smoking and higher IMT values was proven in the adult population [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Cardiovascular Risk Factors in Patients with Juvenile Idiopathic Arthritis

et al. 2023

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Introduction: The aim of this study was to assess the exposure to cardiovascular disease (CVD) risk factors in patients with juvenile idiopathic arthritis (JIA). Intima–media complex thickness (IMT), selected metabolic parameters and health behaviors were assessed in the course of the study. Methods: The study included study group, which consisted of 45 patients with JIA and 37 healthy age- and sex-matched children in the control group. Analyses in both groups included anthropometric parameters, laboratory tests, IMT and a questionnaire on exposure to modifiable CVD risk factors. Results: The study confirmed that CVD risk factors were present in both groups of patients. Significantly more children with JIA had abnormal BMI (p = 0.006) compared to the control group. Children in the study group were more likely to consume fruit regularly (p = 0.021) and less likely to consume fast food (p = 0.011) and sweetened beverages (p = 0.042) than children in the control group. Only 1 patient with JIA met criteria for ideal cardiovascular health. Dietary habits were not associated with IMT values, BMI, presence of joint pain or biochemical parameters in the study group. Conclusions: Patients with JIA are exposed to cardiovascular risk factors equally to their healthy peers. Ideal cardiovascular health should be pursued in the pediatric population with particular attention paid to patients with chronic diseases (i.e., JIA). The application of carotid artery IMT measurement in the assessment of CVD risk requires studies on a larger group of patients.

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Cardiovascular risk assessment with carotid ultrasound in rheumatoid arthritis

Cited by 5 publications

References 31 publications

Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy

Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy

Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre Experience with Carotid Intima-Media Measurements

Assessment of Cardiovascular Risk Factors in Patients with Juvenile Idiopathic Arthritis

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