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Accelerated Atherosclerosis in Rheumatoid Arthritis
Author(s) -
SZEKANECZ ZOLTÁN,
KEREKES GYÖRGY,
DÉR HENRIETT,
SÁNDOR ZSUZSA,
SZABÓ ZOLTÁN,
VÉGVÁRI ANIKÓ,
SIMKOVICS ENIKÖ,
SOÓS LILLA,
SZENTPÉTERY ÁGNES,
BESENYEI TIMEA,
SZÜCS GABRIELLA,
SZÁNTÓ SÁNDOR,
TAMÁSI LÁSZLÓ,
SZEGEDI GYULA,
SHOENFELD YEHUDA,
SOLTÉSZ PÁL
Publication year - 2007
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1422.036
Subject(s) - medicine , endothelial dysfunction , rheumatoid arthritis , dyslipidemia , immunology , inflammation , disease
Abstract : Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. Both traditional, Framingham risk factors and inflammation‐associated factors are involved in RA‐associated atherosclerosis. Among imaging techniques, the early determination of common carotid intima‐media thickness (ccIMT), flow‐mediated vasodilation (FMD), and nitroglycerine‐mediated vasodilation (NMD) may be useful to determine atherosclerosis and endothelial dysfunction. We and others found increased ccIMT and impaired FMD in RA patients. Among immunological and metabolic laboratory markers, anticyclic citrullinated peptide (anti‐CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, pro‐inflammatory cytokines including tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), Th0/Th1 T cells, homocysteine, dyslipidemia, decreased folate and vitamin B12 production, and impaired paraoxonase activity may all be involved in the development of vascular disease in RA. The early diagnosis of endothelial dysfunction and atherosclerosis, active immunosuppressive treatment, the use of drugs that control atherosclerosis, changes in sedentary lifestyle, and the close follow‐up of RA patients may help to minimize cardiovascular risk in these individuals.