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Prospective assessment of cardiovascular risk parameters in patients with rheumatoid arthritis
Bożena Targońska-Stępniak1, Mariusz Piotrowski2, Robert Zwolak2
1Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, ul. Jaczewskiego 8, 20-950, Lublin, Poland. bozena.stepniak@umlub.pl.
Insights
Rheumatoid arthritis patients showed increased atherosclerosis over six years, indicated by higher carotid intima media thickness (cIMT). Monitoring is crucial for those with plaques and males due to elevated cardiovascular risk.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Biology
Background:
- Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) risk.
- Prospective studies are needed to assess CV risk progression in RA patients.
Purpose of the Study:
- To evaluate changes in CV risk parameters over a 6-year period in RA patients.
- To compare CV risk parameters between RA patients and healthy controls.
Main Methods:
- 41 RA patients and 23 healthy controls were assessed.
- Parameters included traditional CV risk factors, carotid intima media thickness (cIMT), QTc duration, and NT-proBNP at baseline (T0) and 6-year follow-up (T6).
Main Results:
- RA patients showed a significant increase in cIMT over 6 years, indicating atherosclerosis progression.
- RA patients had higher cIMT than controls at both T0 and T6.
- Male RA patients exhibited unfavorable metabolic parameters and higher cIMT compared to females at T6.
Conclusions:
- Established RA leads to significant atherosclerosis exacerbation over 6 years, evidenced by increased cIMT.
- Patients with atherosclerotic plaques and males require vigilant CV risk monitoring.
- Traditional CV risk factors appear more critical than inflammatory activity in long-standing RA.
Background:
The study presents a prospective follow-up assessment of cardiovascular (CV) risk parameters in patients with rheumatoid arthritis (RA) in comparison with control subjects.
Methods:
The study group consisted of 41 RA patients. The following parameters were assessed at subsequent visits [initial (T0), follow-up after 6 years (T6)]: traditional CV risk factors, carotid intima media thickness (cIMT), QTc duration, serum concentration of amino-terminal pro-brain natriuretic peptide (NT-proBNP). A comparative cIMT assessment was performed on 23 healthy controls of comparable age.
Results:
The mean (SD) cIMT value in RA patients was significantly higher at T6 than at T0 [0.87 (0.21) vs 0.76 (0.15) mm, p < 0.001], the increase in patients with atherosclerotic plaques was noted. Patients with plaques were significantly older, had higher inflammatory parameters. The mean cIMT was significantly higher in RA patients than in controls at both T6, T0 visits. Certain traditional CV risk factors exacerbated during follow up. Unfavorable metabolic parameters and significantly higher cIMT were found in male patients than in female patients at T6. During follow-up, no significant differences in NT-proBNP, QTc were found. There were no significant relationships between cIMT, NT-proBNP, QTc and parameters of disease activity at T6.
Conclusions:
During the 6-year course of established RA, significant exacerbation of atherosclerosis was found, revealed by higher cIMT. A careful monitoring should be applied to patients with atherosclerotic plaques and of male gender due to higher burden of CV risk. In long-standing disease, traditional CV risk factors seem to play a key role, beyond the inflammatory activity.
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