TY - JOUR
T1 - Risk Factors Associated with Different Stages of Atherosclerosis in Colombian Patients with Rheumatoid Arthritis
AU - Rojas-Villarraga, Adriana
AU - Ortega-Hernandez, Oscar Danilo
AU - Gomez, Luis F.
AU - Pardo, Aryce L.
AU - López-Guzmán, Silvia
AU - Arango-Ferreira, Camila
AU - Hincapie, Maria Eugenia
AU - Betancur, Juan F.
AU - Pineda-Tamayo, Ricardo
AU - Diaz, Francisco J.
AU - Anaya, Juan Manuel
N1 - Funding Information:
We thank all participants in this study and our colleagues Lina-Marcela Diaz-Gallo, John Castiblanco, Luis M. Gomez, and Aura L. Zapata for contributions. This work was supported by the “Centro Integrado para el Desarrollo de la Investigación (CIDI),” Universidad Pontificia Bolivariana, Medellín (964-11/06-53), and by grants from Fundación TCC, Medellín, School of Medicine, Universidad del Rosario, Bogota, Colombia, and the Fernando Chalem Rheumatology Award to J-MA.
Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/10
Y1 - 2008/10
N2 - Objectives: Rheumatoid arthritis (RA) is associated with an increased prevalence of cardiovascular disease (CVD). Since atherosclerosis development is a gradual process of damage inside the artery wall, and the phenotype-genotype correlation of complex diseases may vary depending on ethnicity, we sought to investigate the influence of clinical features, routine inflammatory markers, and the genetic component of RA on different stages of atherosclerosis in northwestern Colombian patients with RA. Methods: A group of 140 patients with RA were enrolled in this study. All patients underwent a noninvasive evaluation of endothelial function by flow-mediated vasodilation (FMV) and an assessment of carotid intima-media thickness (IMT) by high-resolution B-mode ultrasonography. The patients were classified into 3 categories: endothelial dysfunction (FMV <5%), increased IMT (0.91-1.29 mm), and plaque (IMT >1.30 mm). The risk of being in each category was assessed by investigating traditional and nontraditional cardiovascular risk factors. For each stage of atherosclerosis development, we searched for nontraditional risk factors that were significantly associated with the stage after adjusting for traditional risk factors and current age. Results: Rheumatoid factor seropositivity was significantly associated with endothelial dysfunction (adjusted odds ratio, AOR = 3.0). A duration of RA >10 years (AOR = 29.0) and being a carrier of an HLA-DRB1 shared epitope allele (AOR = 4.8) were associated with atherosclerotic plaque. No association of extra-articular manifestations, anticyclic citrullinated peptide (anti-CCP3) antibodies, and tumor necrosis factor -308 polymorphism with CVD was found. Conclusions: Our results reveal the presence of RA-related risk factors for CVD which act independently of traditional risk factors. These factors can be used by clinicians to predict CVD in RA patients, and this data should assist in the development of public health policies in our population for the improvement of patient outcomes.
AB - Objectives: Rheumatoid arthritis (RA) is associated with an increased prevalence of cardiovascular disease (CVD). Since atherosclerosis development is a gradual process of damage inside the artery wall, and the phenotype-genotype correlation of complex diseases may vary depending on ethnicity, we sought to investigate the influence of clinical features, routine inflammatory markers, and the genetic component of RA on different stages of atherosclerosis in northwestern Colombian patients with RA. Methods: A group of 140 patients with RA were enrolled in this study. All patients underwent a noninvasive evaluation of endothelial function by flow-mediated vasodilation (FMV) and an assessment of carotid intima-media thickness (IMT) by high-resolution B-mode ultrasonography. The patients were classified into 3 categories: endothelial dysfunction (FMV <5%), increased IMT (0.91-1.29 mm), and plaque (IMT >1.30 mm). The risk of being in each category was assessed by investigating traditional and nontraditional cardiovascular risk factors. For each stage of atherosclerosis development, we searched for nontraditional risk factors that were significantly associated with the stage after adjusting for traditional risk factors and current age. Results: Rheumatoid factor seropositivity was significantly associated with endothelial dysfunction (adjusted odds ratio, AOR = 3.0). A duration of RA >10 years (AOR = 29.0) and being a carrier of an HLA-DRB1 shared epitope allele (AOR = 4.8) were associated with atherosclerotic plaque. No association of extra-articular manifestations, anticyclic citrullinated peptide (anti-CCP3) antibodies, and tumor necrosis factor -308 polymorphism with CVD was found. Conclusions: Our results reveal the presence of RA-related risk factors for CVD which act independently of traditional risk factors. These factors can be used by clinicians to predict CVD in RA patients, and this data should assist in the development of public health policies in our population for the improvement of patient outcomes.
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U2 - 10.1016/j.semarthrit.2008.01.019
DO - 10.1016/j.semarthrit.2008.01.019
M3 - Article
C2 - 18395773
AN - SCOPUS:52149121712
SN - 0049-0172
VL - 38
SP - 71
EP - 82
JO - Seminars in Arthritis and Rheumatism
JF - Seminars in Arthritis and Rheumatism
IS - 2
ER -
