Traditional cardiovascular risk factors or inflammation: Which factors accelerate atherosclerosis in arthritis patients?. (1st June 2017)

• Record Type: Journal Article
• Authors: Dalbeni, A.; Giollo, A.; Tagetti, A.; Atanasio, S.; Orsolini, G.; Cioffi, G.; Ognibeni, F.; Rossini, M.; Minuz, P.; Fava, C.; Viapiana, O.
• Is Part Of: International journal of cardiology. Volume 236(2017)
• Page Start: 488
• Page End: 492
• Publication Date: 2017-06-01
• Subjects: ACE angiotensin converting enzyme -- AS ankylosing spondylitis -- ASDAS-CRP ankylosing spondylitis disease activity score -- BMI body mass index -- cDC carotid distensibility -- cIMT carotid intima-media thickness -- COX cyclooxygenase -- CRP C-reactive protein -- CVDs cardiovascular diseases -- CVEs cardiovascular events -- DAS28-CRP disease activity score 28 -- DMARD disease modifying anti-rheumatic drug -- ESR erythrocyte sedimentation rate -- EULAR European League Against Rheumatism -- NSAIDs non-steroidal anti-inflammatory drugs -- PsA psoriatic arthritis -- RA rheumatoid arthritis -- SBP systolic blood pressure -- SD standard deviation -- SEM standard error of the mean -- US ultrasound examination; Rheumatoid arthritis -- Psoriatic arthritis -- Ankylosing spondylitis -- Atherosclerotic plaques -- Intima-media thickness -- Carotid distensibility -- Traditional risk factors; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.01.072
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Patients with chronic inflammatory arthritis experience an increased incidence of cardiovascular (CV) events. In addition to visualizing atherosclerotic plaques, ultrasound examinations (USs) of the carotid arteries permit the measurement of subclinical markers of atherosclerosis, such as intima-media thickness (cIMT) and carotid segmental distensibility (cDC). The aims of the study were to identify the determinants of atherosclerosis acceleration (plaques, cIMT and cDC) in a sample of patients suffering from chronic arthritis and to compare these patients with a control group of people with ≤ 1 traditional risk factor (TRF) for CV disease. Methods: We recruited 137 patients with rheumatoid arthritis (RA), 43 patients with psoriatic arthritis (PsA), 28 patients with ankylosing spondylitis (AS) and 48 healthy volunteers without histories of previous CV events. These patients underwent carotid artery US examinations using dedicated hardware. Results: Regression and multivariate analyses demonstrated that only age ( p < 0.001) was consistently associated with cDC, cIMT and atherosclerotic plaques, both in the entire sample of patients with arthritis and in the subgroup of patients with RA. Among modifiable TRFs for cardiovascular disease, only hypertension, diabetes mellitus and smoking exhibited associations with some carotid phenotypes, with borderline significance. When patients with RA carrying ≤ 1 TRF were compared with control subjects carrying ≤ 1 TRF, only cDC was slightly lower in the RA group than in the control group. Conclusions: Age is the major determinant of subclinical atherosclerosis in patients with different types of arthritis, as the contributions of other TRFs and disease activity and duration indices to the disease seem to be limited.