Cardiovascular Events Risk Factors in Patients with Rheumatoid Arthritis

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І. М. Фуштей
С. Л. Подсевахіна
О. В. Ткаченко
А. І. Паламарчук
О. С. Чабанна

Abstract

The objective: is to assess cardiovascular risk and fatal cardiovascular events with consideration of classical and additional cardiovascular risk factors in patients with rheumatoid arthritis.

Materials and methods. 56 patients with rheumatoid arthritis aged 48,7±9,52 years were examined. The average disease duration was 9,8±2,7 years. In all patients, classical risk factors of cardiovascular diseases development were determined. 10-year coronary risk according to theFramingham scale and a 10-year fatal risk according to the SCORE scale were calculated for all patients. As additional cardiovascular risk factors markers of systemic inflammation, parameters of the hemostasis system, markers of endothelial dysfunction and damage were studied.

Results. At screening for classic cardiovascular factors, the 10-year coronary risk according to the Framingham scale in patients with rheumatoid arthritis was 4,0 %, which was significantly lower than the corresponding risk for a population of a comparable gender and age without rheumatoid arthritis. The 10-year risk of fatal cardiovascular events according to the SCORE scale in the examined patients was 1,0 %, which can be considered as low level of risk. Analysis of additional cardiovascular risk factors allowed to reveal an increase in the C-reactive protein and fibrinogen levels, and a decrease of APTT one. Correlations were revealed between the activity of system inflammation and changes in the hemostasis system (platelet count, APTT, fibrinogen level). Patients with RA showed signs of endothelial damage and its dysfunction, which were significantly correlated with parameterd of system inflammation.

Conclusion. The risk of cardiovascular pathology development and fatal cardiovascular events in patients with rheumatoid arthritis, calculated only with classical risk factors scales, is close to the general population one. An analysis of additional risk factors indicates that patients with rheumatoid arthritis show signs of endothelial damage and dysfunction, as well as increased prothrombogenic potential, which are directly related to the activity of systemic inflammation and contribute to the development of high cardiovascular risk in rheumatoid arthritis.

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How to Cite
Фуштей, І. М., Подсевахіна, С. Л., Ткаченко, О. В., Паламарчук, А. І., & Чабанна, О. С. (2020). Cardiovascular Events Risk Factors in Patients with Rheumatoid Arthritis. Family Medicine, (3), 29–33. https://doi.org/10.30841/2307-5112.3.2020.211397
Section
For practicing physicians
Author Biographies

І. М. Фуштей, Zaporizhzhya Medical Academy of Postgraduate Education

Ivan M. Fustey,

Department of Therapy, Clinical Pharmacology and Endocrinology

С. Л. Подсевахіна, Zaporizhzhya Medical Academy of Postgraduate Education

Svitlana L. Posevakhina,

Department of Therapy, Clinical Pharmacology and Endocrinology

О. В. Ткаченко, Zaporizhzhya Medical Academy of Postgraduate Education

Olha V. Tkachenko,

Department of Therapy, Clinical Pharmacology and Endocrinology

А. І. Паламарчук, Zaporizhzhya Medical Academy of Postgraduate Education

Oleksandr I. Palamarchuk,

Department of Therapy, Clinical Pharmacology and Endocrinology

О. С. Чабанна, Zaporizhzhya Medical Academy of Postgraduate Education

Olena S. Chabanna,

Department of Therapy, Clinical Pharmacology and Endocrinology

References

Березин А.Е. Ревматоидный артрит и кардиоваскулярный риск / А.Е. Березин // Український ревматологічний журнал. – 2013. – № 52 (2). – С. 23–29.

Горбунова Ю.Н. Кардиоваскулярный риск у больных ранним ревматоидным артритом до назначения базисной противовоспалительной терапии (предварительные данные исследования РЕМАРКА) / Ю.Н. Горбунова, Д.С. Новикова, Т.В. Попкова [и др.] / Научно-практическая ревматология. – 2014. – № 52 (4). – С. 381–386.

Удачкина Е.В. Прогрессирование атеросклероза сонных артерий у больных ранним ревматоидным артритом на фоне противоревматической терапии, проводимой по принципу «Лечение до достижения цели» / Е.В. Удачкина, Д.С. Новикова, Т.В. Попкова [и др.] // Научно-практическая ревматология. – 2018. – № 56 (4). – С. 449–455.

Arts E.E. Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms / E.E. Arts, C.D. Popa, A.A. Den Broeder [et al.] // Ann. Rheum. Dis. – 2016. – № 75. – Р. 674–680.

Babaeva A.R. Low-dose anti-cytokine treatment impacts on heart failure with preserved ejection fraction in active rheumatoid arthritis / A.R. Babaeva, M.N. Usachova, K.S. Solodenkova [et al.] // European Journal of Heart Failure, European Society of Cardiology (ESC). – 2016. – Vol. 18 (S1). – P. 522–563.

Bernardi S. The Complex Interplay between Lipids, Immune System and Interleukins in Cardio-Metabolic Diseases / S. Bernardi, A. Marcuzzi, E. Pisciani [et al.] // J. Mol. Sci. – 2018. – Vol. 19 (12). – P. 4058.

Chung C.P. Lipoprotein subclasses determined by nuclear magnetic resonance spectroscopy and coronary atherosclerosis in patients with rheumatoid arthritis / C.P. Chung, A. Oeser, P. Raggi, T. Sokka // J. Rheumatol. – 2010. – Vol. 37 (8). – P. 633–1638.

Dong Q.T. Impact of glucose and lipid markers on the correlation of calculated and enzymatic measured low-density lipoprotein cholesterol in diabetic patients with coronary artery disease / Q.T. Dong, Y. Gao, N.Q. Wu [et al.] // J. Clin.Lab. – 2018. – Vol. 32 (5). – Р. e22399.

El-Barbary A.M. Effect of atorvastatin on inflammation and modification of vascular risk factors in rheumatoid arthritis / A.M. El-Barbary, M.S. Hussein, E.M. Rageh [et al.] // J. Rheumatol. – 2011. – Vol. 38 (2). – Р. 229–35.

Foster W. Inflammation and microvascular and macrovascular endothelial dysfunction in rheumatoid arthritis: Effect of treatment/ W. Foster, D. Carruthers, G.Y.H. Lip, A.D. Blann // J. Rheumatol. – 2010. – Vol. 37 (4). – P. 711–716.

Gwinnutt J.M. Twenty-Year Outcome and Association Between Early Treatment and Mortality and Disability in an Inception Cohort of Patients With Rheumatoid Arthritis: Results From the Norfolk Arthritis Register / J.M. Gwinnutt, D.P.M. Symmons, A.J. MacGregor // Arthritis Research. – 2017. – Vol. 69 (8). – Р. 1566–1575.

Listing J. Mortality in rheumatoid arthritis: the impact of disease activity, treatment with glucocorticoids, TNFα inhibitors and rituximab / J. Listing, J. Kekow, B. Manger [et al.] // Ann. Reum. Dis. – 2015. – Vol. 74 (2). – Р. 415–421.

Montgomery J.E. Metabolic biomarkers for predicting cardiovascular disease / J.E. Montgomery, J.R. Brown // Vasc. Health Risk Manag. – 2013. – Vol. 9. – Р. 37–45.

Navarro-Millan I. Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis / I. Navarro-Millan, Shuo Yang, S.L. DuVall // Ann. Rheum. Dis. – 2016. – № 75 (2). – Р. 341–347.

Pozzi F.S. Plasma kinetics of an LDL-like non-protein nanoemulsion and transfer of lipids to high-density lipoprotein (HDL) in patients with rheumatoid arthritis / F.S. Pozzi, R.C. Maranhao, L.K. Guedes [et al.] //. J. Clin. Lipidol. – 2015. – Vol. 9 (1). – Р. 72–80.

Vizzardi E. Evaluation of Ascending Aorta Wall in Rheumatoid Arthritis by Tissue and Strain Doppler Imaging During Anti-Tumor Necrosis Factor-α Therapy / E. Vizzardi, I. Cavazzana, E. Sciatti [et al.] // Clin. Cardiol. – 2014. – Vol. 37 (12). – Р. 738–743.