Carotid artery intima-media thickness and brachial artery flow-mediated vasodilatation in patients with rheumatoid arthritis

Veselinović, Mirjana; Živković, Vladimir; Tončev, Slavčo; Tasić, Nebojša; Bogdanović, Vesna; Djuric, Dragan; Jakovljevic, Vladimir

doi:10.1024/0301-1526/a000220

Cited by 18 publications

(19 citation statements)

References 21 publications

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“…In our study, the RA patients’ CIMT scores were significantly elevated. Similarly, Veselinovic et al determined that their RA patients’ CIMT scores were significantly higher than in the controls, and the brachial artery flow-mediated vasodilatation values were lower, which was attributed to the development of endothelial dysfunction and accelerated atherosclerosis13 ) . Adhikari et al also studied early RA patients, and they reported the same findings as previous researchers12 ) .…”

Section: Discussionmentioning

confidence: 96%

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Is There Any Relationship between Joint Destruction and Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis?

Tutoğlu

Boyacı

et al. 2014

J Phys Ther Sci

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[Purpose] The purpose of this study was to investigate the possible relationship between joint destruction and carotid intima-media thickness in patients with rheumatoid arthritis. [Subjects and Methods] Thirty-four RA patients and 31 healthy controls were enrolled in this study. The disease activity for 28 joints was recorded for each patient using the erythrocyte sedimentation rate (DAS28ESR), a visual analog scale (VAS0–10 cm), and a disability index, the health assessment questionnaire (HAQ). X-ray imagesof the patients were scored according to the modified Sharp/van der Heijde method, and the common carotid intimal medial thickness (CIMT) was automatically measured with software using high-resolution Doppler ultrasound. [Results] Contrary to our hypothesis, the modified total Sharp score (mTSS) and CIMT were not significantly associated. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels of the RA patients and the right CIMT, left CIMT, and mean CIMT scores were significantly elevated. Positive correlation was detected between the mean CIMT score and age, CRP levels, LDL concentration and triglycerides (TG) level. In the regression model, where the mean CIMT was the independent variable and age, CRP, LDL, and TG were dependent variables, age was found to be an independent predictor of CIMT. [Conclusions] Patients suffering from RA require close monitoring for cardiovascular risks, and the comorbidity of age-related cardiovascular disease should not be overlooked.

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Section: Discussionmentioning

confidence: 96%

“…In addition to predicting the presence of local atheroma, the findings of CIMT can reveal possible damage to the arterial system11 ) . Recent studies have shown increased CIMT scores in RA patients in contrast to healthy controls12, 13 ) .…”

Section: Introductionmentioning

confidence: 99%

Is There Any Relationship between Joint Destruction and Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis?

Tutoğlu

Boyacı

et al. 2014

J Phys Ther Sci

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“…Other observational studies have demonstrated an association between corticosteroid use and lower rates of subclinical atherosclerosis compared to patients not using steroids [133]. Veselinovic and colleagues demonstrated that FMD is higher in RA patients treated with corticosteroids versus no therapy [124]. This study conflicts with a randomized prospective study, by Hafstrom, showing that addition of steroids to DMARD therapy does not improve endothelial function in RA patients [125].…”

Section: Effects Of Pharmacologic Interventions On Endothelial Funmentioning

confidence: 99%

“…The use of statins as disease modifying agents and as primary prevention for CVD in patients with chronic inflammatory diseases has also received interest. Statin therapy has been shown to reduce disease severity in patients with RA and has gained attention for use as a disease-modifying agent in other inflammatory diseases [124,125,133,134,135]. Statins have been also been shown to improve endothelium-dependent vasodilation in patients with RA and SLE [126,134,136,137].…”

Section: Effects Of Pharmacologic Interventions On Endothelial Funmentioning

confidence: 99%

Endothelial Dysfunction in Chronic Inflammatory Diseases

Steyers

Miller

2014

IJMS

378

299

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Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD). As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-α (tumor necrosis factor-α), reactive oxygen species, oxidized LDL (low density lipoprotein), autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-α-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population.

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“…+ DMARD30 daysCompared to baselineFMD5.0 % ± 1.9 vs 4.3 % ± 1.6 (NS)9Foster et al [47]England310.7-Methylprednisolone 500 mg (i.v. )Single doseCompared to baselineFMD3.3 % vs 3.1 % (NS)4Veselinovic et al [48]Serbia525.723.69 ± 0.84Prednisolone 7.5 mg/day (p.o.) + DMARDAt least 1 yearRA patients without GCFMD9.16 % ± 7.03 vs 12.6 % ± 5.49 P = 0.0057Radhakutty et al [49]Australia18--Prednisolone 6 mg/day (p.o.…”

Section: Effects Of Gc On Endothelial Function In Ramentioning

confidence: 99%

Glucocorticoids and endothelial function in inflammatory diseases: focus on rheumatoid arthritis

et al. 2016

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Rheumatoid arthritis (RA) is the most common systemic autoimmune disease characterized by articular and extra-articular manifestations involving cardiovascular (CV) diseases. RA increases the CV mortality by up to 50 % compared with the global population and CV disease is the leading cause of death in patients with RA. There is growing evidence that RA favors accelerated atherogenesis secondary to endothelial dysfunction (ED) that occurs early in the course of the disease. ED is a functional and reversible alteration of endothelial cells, leading to a shift of the actions of the endothelium towards reduced vasodilation, proinflammatory state, proliferative and prothrombotic properties. The mechanistic links between RA and ED have not been fully explained, but growing evidence suggests a role for traditional CV factors, auto-antibodies, genetic factors, oxidative stress, inflammation and iatrogenic interventions such as glucocorticoids (GCs) use. GCs have been used in RA for several decades. Whilst their deleterious CV side effects were described in the 1950s, their effect on CV risk associated with inflammatory arthritis remains subject for debate. GC might induce negative effects on endothelial function, via a direct effect on endothelium or via increasing CV risk factors. Conversely, they might actually improve endothelial function by decreasing systemic and/or vascular inflammation. The present review summarizes the available data on the impact of GCs on endothelial function, both in normal and inflammatory conditions, with a special focus on RA patients.

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Carotid artery intima-media thickness and brachial artery flow-mediated vasodilatation in patients with rheumatoid arthritis

Abstract: In patients with RA, FMD was impaired and IMT was increased, indicating early endothelial dysfunction and accelerated atherosclerosis. Early treatment of disease may reduce the risk of atherosclerosis in RA.

Cited by 18 publications

References 21 publications

Is There Any Relationship between Joint Destruction and Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis?

Is There Any Relationship between Joint Destruction and Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis?

Endothelial Dysfunction in Chronic Inflammatory Diseases

Glucocorticoids and endothelial function in inflammatory diseases: focus on rheumatoid arthritis

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