Severe atherosclerosis in rheumatoid arthritis and hyperhomocysteinemia: Is there a link?

Bouchti, I. El; Sordet, Christelle; Kuntz, J. L.; Sibilia, Jean

doi:10.1016/j.jbspin.2007.07.022

Cited by 9 publications

(4 citation statements)

References 13 publications

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“…More so, inflammatory biomarkers of cardiovascular risk less prevalent in the general population are more accurate in the course of RA [ 37 , 38 ]. May it be the case for HHcy which is over two times more frequent in RA patients than in the general population (20–42 % versus 5–7 % for RA and general populations respectively) [ 29 , 39 ]. However, only a few epidemiological studies have investigated the putative link between HHcy and CVD in RA populations (Table 1 ) [ 10 , 21 , 40 – 43 ].…”

Section: Association Between Hyperhomocysteinemia and Cardiovascular mentioning

confidence: 99%

Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patients

Essouma¹,

Noubiap

2015

Biomark Res

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Rheumatoid arthritis (RA) is a chronic inflammatory disease that preferentially affects joints, and characterized by an approximately two-fold increased risk of cardiovascular diseases compared with the general population. Beyond classical cardiovascular risk factors, systemic inflammatory markers are primarily involved. Hence, anti-inflammatory strategies such as homocysteine-lowering interventions are warranted. Indeed, hyperhomocysteinemia is commonly found in RA patients as a result of both genetic and non-genetic factors including older age, male gender, disease-specific features and disease-modifying antirheumatic drugs. Most importantly in the pathophysiology of hyperhomocysteinemia and its related cardiovascular diseases in RA, there is a bi-directional link between immuno-inflammatory activation and hyperhomocysteinemia. As such, chronic immune activation causes B vitamins (including folic acid) depletion and subsequent hyperhomocysteinemia. In turn, hyperhomocysteinemia may perpetrate immuno-inflammatory stimulation via nuclear factor ƙappa B enhancement. This chronic immune activation is a key determinant of hyperhomocysteinemia-related cardiovascular diseases in RA patients. Folate, a homocysteine-lowering therapy could prove valuable for cardiovascular disease prevention in RA patients in the near future with respect to homocysteine reduction along with blockade of subsequent oxidative stress, lipid peroxidation, and endothelial dysfunction. Thus, large scale and long term homocysteine-lowering clinical trials would be helpful to clarify the association between hyperhomocysteinemia and cardiovascular diseases in RA patients and to definitely state conditions surrounding folic acid supplementation. This article reviews direct and indirect evidence for cardiovascular disease prevention with folic acid supplementation in RA patients.

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Section: Association Between Hyperhomocysteinemia and Cardiovascular mentioning

confidence: 99%

Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patients

Essouma¹,

Noubiap

2015

Biomark Res

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“…According to ObradovićTomasević et al [45], exces sively high levels of HCY occur in 39%, and according to Bouchti et al [46] in 20-40% of patients with RA. One of the reasons for this elevated HCY concentration is that the MTHFR TT gene polymorphism is more preva lent in these patients than in the gene ral population [44].…”

Section: Homocysteine In Rheumatoid Arthritismentioning

confidence: 97%

“…Homocysteine levels are also higher in patients treated with methotrexate. It has also been shown that HHCY in patients with RA significantly increases the risk of CVD [46]. High levels of HCY in serum are also important prognostic factors.…”

Section: Homocysteine In Rheumatoid Arthritismentioning

confidence: 99%

The importance of homocysteine in the development of cardiovascular complications in patients with rheumatoid arthritis

et al. 2020

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Rheumatoid arthritis (RA) not only leads to disability due to joint changes, but also significantly shortens the life expectancy of patients, mainly due to more frequent occurrence of heart attacks and strokes. Accelerated atherosclerosis in these patients is caused, among other factors, by high homocysteine (HCY) concentration in blood. Numerous studies have shown that treatment with vitamin B significantly reduces the concentration of HCY in blood, but does not reduce the risk of heart diseases. Recent studies have shown, however, that folic acid (FA) administration reduces the risk of stroke by 10–20%. Due to the fact that in patients with RA strokes are more frequent than in the general population and hyperhomocysteinemia (HHCY) is often found, determination of HCY concentration in blood is advisable, and in persons with HHCY it is recommended to use FA in primary and secondary stroke prevention.

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“…The increased levels of homocysteine caused by methotrexate therapy occur more often to patients heterozygous for the C677T mutation. Normal homocysteine levels are restored by folic acid supplementation (El Bouchti, Sordet et al 2008). …”

Section: Hyperomocysteinemiamentioning

confidence: 99%

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

Giannelou¹,

Gravani²,

Papadaki³

et al. 2011

Autoimmune Disorders - Pathogenetic Aspects

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Severe atherosclerosis in rheumatoid arthritis and hyperhomocysteinemia: Is there a link?

Cited by 9 publications

References 13 publications

Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patients

Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patients

The importance of homocysteine in the development of cardiovascular complications in patients with rheumatoid arthritis

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

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