Subclinical atherosclerosis among rheumatoid arthritis patients without overt cardiovascular risk factors

Sahari, Narisa Sulaiman; Shaharir, Syahrul Sazliyana; Ismail, Mahamod; Sakthiswary, Rajalingham; Said, Mohd Fuaad

doi:10.3109/14397595.2014.891497

Cited by 12 publications

(13 citation statements)

References 40 publications

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“…Patients with RA, compared with the general population, have an increased risk of CVD, which is probably related to both traditional CV risk factors and RA-specific characteristics, particularly inflammatory disease activity [1, 2, 13]. Inflammation may also influence traditional cardiovascular risk factors, such as lipoproteins [13].…”

Section: Discussionmentioning

confidence: 99%

“…Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with reduced lifespan and excess mortality compared with the general population [1]. The main cause of death is cardiovascular (CV) disease (CVD), accounting for 30-50% of premature deaths observed [2, 3]. Current findings suggest significantly improved overall CV mortality in RA patients in recent years [4].…”

Section: Introductionmentioning

confidence: 99%

“…Current findings suggest significantly improved overall CV mortality in RA patients in recent years [4]. Beyond traditional risk factors, chronic, systemic inflammation is responsible for the development of accelerated atherosclerosis and heart disease [2, 5–7]. It has been suggested that low disease activity is sufficient to achieve a protective effect against CVD [8, 9].…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Cardiovascular Risk Profile in Rheumatoid Arthritis Patients with Low Disease Activity

Targońska-Stępniak

Biskup²,

Biskup³

et al. 2019

BioMed Research International

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Objective. Patients with rheumatoid arthritis (RA) have an excess risk of cardiovascular (CV) disease (CVD). The objective of the study was to compare CV risk profile in female and male RA patients with low disease activity. Materials and Methods. The study group consisted of 70 RA patients with continuous low disease activity and no CVD (54 women, 16 men) and 33 healthy controls of comparable age. The groups were assessed for blood pressure, serum amino-terminal pro-brain natriuretic peptide (NT-proBNP), carotid intima media thickness (cIMT), electrocardiography, ejection fraction (EF), and diastolic dysfunction (DD). Results. Significantly higher burden of atherosclerosis, as revealed by higher cIMT, was found in males [0.93 (0.2) mm] vs females [0.80 (0.2) mm]. The risk of 10-year CVD was significantly higher in men than in women with RA. High/very high risk of fatal CVD was found in 62.5% of male patients. Males were significantly more often current/ex-smokers and had lower HDL-cholesterol and higher atherogenic index. There were no significant differences in NT-proBNP, QTc duration, and parameters of EF and DD. Conclusions. In RA patients with continued low disease activity, a higher burden of atherosclerosis was found in males than in females. The data suggest a significant impact of traditional CV risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gender Differences in Cardiovascular Risk Profile in Rheumatoid Arthritis Patients with Low Disease Activity

Targońska-Stępniak

Biskup²,

Biskup³

et al. 2019

BioMed Research International

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“…Increased intima media thickness (IMT) of the common carotid artery is a key indicator of early vascular damage in the process of atherosclerosis (3, 4). RA patients have signs of subclinical atherosclerosis, revealed by increased carotid IMT (5, 6). Moreover, increased IMT has been demonstrated in patients without overt CVD to herald enlarged risk for cardiac events and stroke (7).…”

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Monocyte Subsets Reveals Specific and Distinctive Molecular Signatures Associated With Cardiovascular Disease in Rheumatoid Arthritis

et al. 2019

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Objectives: This study, developed within the Innovative Medicines Initiative Joint Undertaking project PRECISESADS framework, aimed at functionally characterize the monocyte subsets in RA patients, and analyze their involvement in the increased CV risk associated with RA. Methods: The frequencies of monocyte subpopulations in the peripheral blood of 140 RA patients and 145 healthy donors (HDs) included in the PRECISESADS study were determined by flow cytometry. A second cohort of 50 RA patients and 30 HDs was included, of which CD14 + and CD16 + monocyte subpopulations were isolated using immuno-magnetic selection. Their transcriptomic profiles (mRNA and microRNA), proinflammatory patterns and activated pathways were evaluated and related to clinical features and CV risk. Mechanistic in vitro analyses were further performed. Results: CD14 ++ CD16 + intermediate monocytes were extended in both cohorts of RA patients. Their increased frequency was associated with the positivity for autoantibodies, disease duration, inflammation, endothelial dysfunction and the presence of atheroma plaques, as well as with the CV risk score. CD14 + and CD16 + monocyte subsets showed distinctive and specific mRNA and microRNA profiles, along with specific intracellular signaling activation, indicating different functionalities. Moreover, that specific molecular profiles were interrelated and associated to atherosclerosis development and increased CV risk in RA patients. In vitro , RA serum promoted differentiation of CD14 + CD16 − to CD14 ++ CD16 + monocytes. Co-culture with RA-isolated monocyte subsets induced differential activation of endothelial cells. Conclusions: Our overall data suggest that the generation of inflammatory monocytes is associated to the autoimmune/inflammatory response that mediates RA. These monocyte subsets, -which display specific and distinctive molecular signatures- might promote endothelial dysfunction and in turn, the progression of atherosclerosis through a finely regulated process driving CVD development in RA.

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“…Even though anti-CCP-positive patients possess a higher CV risk, there are, to our knowledge, no data to support a direct correlation of this antibody with cfPWV (Pieringer et al 2010 ; Provan et al 2011 ). The presence of RF has been shown to associate with higher cIMT values and endothelial dysfunction in patients with RA (Rojas-Villarraga et al 2008 ; Sahari et al 2014 ), but not directly with aortic stiffness (Mäki-Petäjä et al 2006 ). We are not aware of studies who examined the relationship between ANA and cfPWV.…”

Section: Discussionmentioning

confidence: 99%

The count of tender rather than swollen joints correlates with aortic stiffness in patients with rheumatoid arthritis

et al. 2016

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BackgroundPatients with rheumatoid arthritis (RA) are at a higher cardiovascular (CV) risk in comparison to the general population. CV risk associates closely with aortic stiffness. Aim of this exploration was therefore to evaluate aortic stiffness in patients with RA and to examine its association with various RA associated parameters as well as with traditional CV risk factors.MethodsMeasurements of carotid-femoral pulse wave velocity (cfPWV) were analyzed retrospectively in 38 RA patients and 25 controls. We investigated the statistical difference between cfPWV values in the two groups. Furthermore, we analyzed the associations of cfPWV with laboratory and clinical RA parameters including Disease Activity Score 28 and its components, rheumatoid factor, cyclic citrullinated peptide antibodies, antinuclear antibodies and RA duration. Finally, we explored the relationship of cfPWV with traditional CV risk factors in the RA group.ResultscfPWV was not significantly higher in RA patients in comparison to controls in an adjusted statistical model for confounding factors [−0.587 95 % CI (−1.38 to 0.201), p = 0.144]. Among RA patients there was a statistically significant correlation of cfPWV with age (rho = 0.544, p = 0.001) and the count of tender joints [0.051 95 % CI (0.008–0.207), p = 0.034]. Finally, C-reactive protein associated only marginally with cfPWV [0.105 95 % CI (−0.410 to 0.003), p = 0.053].ConclusionsIn RA patients the number of tender, rather than swollen joints correlates with stiffness of the aorta, as measured through cfPWV. Therefore, RA associated joint pain might play a role in the development of aortic stiffness and thus increase CV risk.

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Subclinical atherosclerosis among rheumatoid arthritis patients without overt cardiovascular risk factors

Abstract: RA patients are at risk for subclinical atherosclerosis despite absence of traditional CV risk co morbidities and active disease was the independent factor associated with it.

Cited by 12 publications

References 40 publications

Gender Differences in Cardiovascular Risk Profile in Rheumatoid Arthritis Patients with Low Disease Activity

Gender Differences in Cardiovascular Risk Profile in Rheumatoid Arthritis Patients with Low Disease Activity

Molecular Characterization of Monocyte Subsets Reveals Specific and Distinctive Molecular Signatures Associated With Cardiovascular Disease in Rheumatoid Arthritis

The count of tender rather than swollen joints correlates with aortic stiffness in patients with rheumatoid arthritis

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