scholarly journals New risk factors for cardiovascular diseases in patients with rheumatoid arthritis

2008 ◽  
Vol 61 (11-12) ◽  
pp. 601-606 ◽  
Author(s):  
Biljana Obradovic-Tomasevic ◽  
Nada Vujasinovic-Stupar ◽  
Ratko Tomasevic
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Epidemiologic Studies ◽  
Clinical Findings ◽  
Continuous Exposure ◽  
Echocardiographic Examination ◽  
The Mean ◽  
Hs Crp ◽  
Hospital Center

Introduction In the last three decades numerous epidemiologic studies have shown the correlation between risk factors and cardiovascular diseases. Clinical research has proven that rheumatoid arthritis patients (RA) have higher prevalence of classical risk factors in relation to general population, and over the last few years there has been an emphasis on some new risk factors which can contribute to cardiovascular diseases (CVD). Material and methods This study examined risk factor values for CVD in 88 patients with RA treated at Rheumatology Department, Clinical Hospital Center, Zemun. All patients have been thoroughly examined (clinical findings, laboratory and echocardiographic examination). Apart from classical factors, 'new' risk factors have been examined in all patients: C-reactive proteine (CRP), high-sensitive C-reactive proteine (hs-CRP) and homocystein. Results It has been determined that RA patients have more frequent higher new risk factors in comparison to classical ones. 84.1% of patients had higher CRP values, 97.1% had hsCRP and 39.5% had homocystein. The mean CRP values, especially hsCRP have been higher in patients with positive rheumatoid factor finding. Discussion Rheumatoid arthritis patients may have worse 'background atherosclerosis' than even subjects matched for classical cardiovascular risk factors. Continuous exposure to high grade systemic inflammation may be linked to accelerated atherosclerosis. Conclusions Timely identification of patients with risk factors, particularly with new risk factors, enables adequate approach in prevention of and treatment for CVD in rheumatoid arthritis patients.

scholarly journals The assessment of diastolic function in patients with rheumatoid arthritis

2009 ◽  
Vol 62 (11-12) ◽  
pp. 522-528 ◽  
Author(s):  
Biljana Obradovic-Tomasevic ◽  
Nada Vujasinovic-Stupar ◽  
Ratko Tomasevic
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Diastolic Function ◽  
Clinical Signs ◽  
Clinical Findings ◽  
Mortality And Morbidity ◽  
Echocardiographic Examination ◽  
Population Mortality ◽  
High Level

Introduction. Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune chronic disease. In comparison with the overall population, mortality and morbidity of RA patients are increased due to cardiovascular diseases. There is increasing evidence that autoimmunity mechanisms are included in pathogenesis of cardiovascular diseases. Isolated disorder of diastolic function can, even with normal heart contractility, lead to heart failure. The aim of this study was to assess diastolic function in RA patients and determine factors causing diastolic dysfunction. Material and methods. The study included 88 patients with RA treated at Rheumatology Department, Clinical Hospital Centre, Zemun. All the patients were thoroughly examined (clinical findings, laboratory and echocardiographic examination). All parameters of diastolic function (mitral and pulmonary flow) were measured. Results. In RA patients 98,9% had diastolic function disorder. This parameter had been changed prior to clinical signs of heart failure and decrease of ejection fraction. Indicators of diastolic function, velocities E, A and their ratio VE/VA, as well as velocities S, D and their ratio VS/VD were lower in patients with positive rheumatoid factor. The patients' age (p<0.01), duration of the disease (p<0.05), high level of cholesterol (p<0.05), triglycerides (p<0.05) and arterial hypertension (p<0.05) were significant factors considerably affecting diastolic function. Conclusion. These findings suggest subclinical myocardial disorder in a great number of RA patients. Apart from early and aggressive treatment of the chronic inflammatory process, it is also necessary to prevent further heart complications by timely recognition and treatment of 'standard' risk factors for cardiovascular diseases.

Epidemiology of Hepatocellular Carcinoma in a Province of Northern Italy: Prevalence of the Risk Factors and Incidence in the Population

1993 ◽  
Vol 79 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Guido Colloredo Mels ◽  
Gioacchino Leandro ◽  
Anna Scorpiniti ◽  
Piero Cristini ◽  
Giovanni Battista Moretti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Incidence Rate ◽  
Epidemiologic Studies ◽  
Northern Italy ◽  
Single Centre ◽  
Men And Women ◽  
The Mean ◽  
Hospital Center

Aims Epidemiologic studies on hepatocellular carcinoma (HCC) in limited geographic areas of Italy are rare, and most of them derive from autopsies. We retrospectively analyzed the prevalence of risk factors (sex, age, HBsAg, alcoholism, cirrhosis) in 137 HCC diagnosed between 1980 and 1989 in a single centre of northern Italy (Bergamo). Results and conclusions One hundred and nine of the HCC (79.6%) occurred in men (M:F = 3.9:1); 35.8% were HBsAg+ and 41.4% had histories of alcoholism. There were significant differences between men and women as regards prevalence of HBsAg+ (40.4% vs 17.9%; p = 0.046) and alcoholism (47.6% vs 17.9%, p = 0.008). The mean age of the patients was 63.6 years (range, 40-82), with significant differences between men and women (62.4 ± 08 vs 68.2 ± 1.4, p = 0.001), between HCC/HBsAg + and HCC/HBsAg– (59.1 ± 1.1 vs 66.1 ± 0.8, p = 0.00001) and between alcoholics and nonalcoholics (61.6 ± 1.1 vs 64.8 ± 0.9; p = 0.03). Liver cirrhosis was associated with HCC in 104/122 cases (data not available for 15 patients) without differences in distribution of sex, age, HBsAg+ or alcoholism between HCC with cirrhosis and HCC without cirrhosis. Incidence was calculated for the surrounding territory of the hospital center (10 towns, districts 5 and 6, USSL 30). Fifty-four cases of HCC were found in this area over the 10-year period, In according with a mean standardized incidence rate (Lombardy population 1971) of 11.7/100,000 inhabitants/year (c.i. 95%, 1.49-21.86).

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

Association between Patients with Metabolic Syndrome and Other Various Factors Defining Metabolic Syndrome: A Cross-Sectional Study

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Diseases ◽  
Abdominal Obesity ◽  
Positive History ◽  
The Metabolic Syndrome ◽  
Study Results ◽  
History Of ◽  
The Mean

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.

scholarly journals PERCENTILE DISTRIBUTION OF CAROTID INTIMA-MEDIA THICKNESS IN THE GENERAL WORKING-AGE POPULATION

2019 ◽  
Vol 34 (1) ◽  
pp. 145-151
Author(s):  
Kaveshnikov Kaveshnikov ◽  
V. N. Serebryakova ◽  
I. A. Trubacheva
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Informed Consent Form ◽  
Gender And Age ◽  
Working Age ◽  
The Mean ◽  
Working Age Population

Objective.To study the gender- and age-specific percentile distribution of carotid intima-media thickness (cIMT) in the unorganized urban working-age population.Material and Methods. Presented data were obtained in the ESSE-RF study in the city of Tomsk (1,412 participants, 25–64 years old without cardiovascular diseases, 59% women). All the surveyed signed voluntary informed consent form to participate in the study. We studied distributions of the mean and maximum cIMT obtained by the automatic and manual measurements, respectively. An error probability of less than 5% was considered statistically significant.Results. Both indicators of cIMT consistently increased with age in both gender groups. Maximum cIMT (max-cIMT) increased stronger than the mean cIMT (mean-cIMT). Compared with data obtained in other studies, the mean-cIMT estimates were distributed closer to the upper pole of the spectrum presented and increased stronger in 35–55-year-old men compared with those in the populations of Central and Southwestern Europe; the mean-cIMT estimates showed the most pronounced gender effect. Similar trends were identified in relation to the max-cIMT distribution.Conclusion. Obtained data allowed for specific assessment of the individual cIMT values by gender and age within the framework of risk stratification among people of working age without cardiovascular diseases. Further studies aimed at clarifying the prognostic role of high cIMT values in general population, taking into account the influence of traditional and new cardiovascular risk factors, can broaden the understanding of the significance of vascular state assessment as one of the key points, linking risk factors to clinical events, for primary prevention of cardiovascular diseases in population.

scholarly journals Rheumatoid arthritis: influence of inflammation and anti-inflammatory therapy on cardiovascular risk factors

2020 ◽  
pp. 32-44
Author(s):  
D. I. Trukhan ◽  
D. S. Ivanova ◽  
K. D. Belus
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Chronic Inflammation ◽  
Pharmacological Intervention ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Rheumatoid arthritis is a frequent and one of the most severe immuno-inflammatory diseases in humans, which determines the great medical and socio-economic importance of this pathology. One of the priority problems of modern cardiac rheumatology is an increased risk of cardiovascular complications in rheumatoid arthritis. In patients with rheumatoid arthritis, traditional cardiovascular risk factors for cardiovascular diseases (metabolic syndrome, obesity, dyslipidemia, arterial hypertension, insulin resistance, diabetes mellitus, smoking and hypodynamia) and a genetic predisposition are expressed. Their specific features also have a certain effect: the “lipid paradox” and the “obesity paradox”. However, chronic inflammation as a key factor in the development of progression of atherosclerosis and endothelial dysfunction plays a leading role in morbidity and mortality from cardiovascular diseases in rheumatoid arthritis. This review discusses the effect of chronic inflammation and its mediators on traditional cardiovascular risk factors and its independent significance in the development of CVD. Drug therapy (non-steroidal anti-inflammatory drugs, glucocorticosteroids, basic anti-inflammatory drugs, genetically engineered biological drugs) of the underlying disease also has a definite effect on cardiovascular risk factors in patients with rheumatoid arthritis. A review of studies on this problem suggests a positive effect of pharmacological intervention in rheumatoid arthritis on cardiovascular risk factors, their reduction to a level comparable to the populations of patients not suffering from rheumatoid arthritis. The interaction of rheumatologists, cardiologists and first-contact doctors (therapist and general practitioner) in studying the mechanisms of the development of atherosclerosis in patients with rheumatoid arthritis will allow in real clinical practice to develop adequate methods for the timely diagnosis and prevention of cardiovascular diseases in patients with rheumatoid arthritis.

scholarly journals Risk factors for development of cardiovascular diseases in rheumatoid arthritis

2017 ◽  
Vol 12 (3) ◽  
pp. 44-44
Author(s):  
Amira Bijedić ◽  
Irma Bijedić ◽  
Suad Bijedić ◽  
Zumreta Kušljugić ◽  
Daniela Lončar
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Diseases

scholarly journals The relation between cardiovascular affection and erosive articular changes in patients with rheumatoid arthritis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M H Hassabelnabi ◽  
N Y Assaf ◽  
H F Zidan ◽  
G M M Abushanab
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Power Doppler ◽  
Premenopausal Women ◽  
Joint Disease ◽  
P Value ◽  
Physical Medicine ◽  
Bone Erosions ◽  
The Mean

Abstract Background rheumatoid arthritis is currently regarded as independent cardiovascular risk factor. Accelerated atherosclerosis considered as an extra-articular manifestation of RA that occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators. Objectives the presented study aimed to find the relation between cardiovascular affection and erosive articular changes in RA. Subjects and Methods The presented study included 40 patients’ men and premenopausal women that were diagnosed with rheumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University, patients underwent laboratory investigation, carotid duplex, musculoskeletal ultrasound and echocardiography. Results Among 40 RA patients, 16 (40%) had erosions in both hands and 24 (60%) without erosion with no statistically significance difference between both sides of hand and feet, only 3 patients (7.5%) had active erosion exhibited by power Doppler. The presence of erosion positively correlated with the mean CIMT (p-value &lt; 0.001) with mean 0.827±0.149, The presence of carotid plaques as a marker of advanced atherosclerosis showed statistically significant value with erosions (p = 0.001). There was positive relation between erosions with disease duration (p-value &lt; 0.001), and negatively with DAS-28 (p = 0.083). Out of 33 patients with positive RF, 16 patients had erosions with statistically significant value (p = 0.017). Conclusion Since the presence of bone erosions was highly associated with higher mean CIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.

scholarly journals High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Maria Fernanda Brandão de Resende Guimarães ◽  
Carlos Ewerton Maia Rodrigues ◽  
Kirla Wagner Poti Gomes ◽  
Carla Jorge Machado ◽  
Claiton Viegas Brenol ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Cardiovascular Risk Factors ◽  
Laboratory Data ◽  
Premature Cardiovascular Disease ◽  
Prevalence Of Obesity ◽  
The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

scholarly journals Total elbow arthroplasty in patients with rheumatoid arthritis

2020 ◽  
Vol 102-B (8) ◽  
pp. 967-980
Author(s):  
Te-Feng A. Chou ◽  
Hsuan-Hsiao Ma ◽  
Jou-Hua Wang ◽  
Shang-Wen Tsai ◽  
Cheng-Fong Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Regression Analysis ◽  
Implant Failure ◽  
Complication Rates ◽  
Younger Patients ◽  
Mode Of Failure ◽  
The Mean ◽  
Meta Regression ◽  
Meta Regression Analysis

Aims The aims of this study were to validate the outcome of total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA), and to identify factors that affect the outcome. Methods We searched PubMed, MEDLINE, Cochrane Reviews, and Embase from between January 2003 and March 2019. The primary aim was to determine the implant failure rate, the mode of failure, and risk factors predisposing to failure. A secondary aim was to identify the overall complication rate, associated risk factors, and clinical performance. A meta-regression analysis was completed to identify the association between each parameter with the outcome. Results A total of 38 studies including 2,118 TEAs were included in the study. The mean follow-up was 80.9 months (8.2 to 156). The implant failure and complication rates were 16.1% (95% confidence interval (CI) 0.128 to 0.200) and 24.5% (95% CI 0.203 to 0.293), respectively. Aseptic loosening was the most common mode of failure (9.5%; 95% CI 0.071 to 0.124). The mean postoperative ranges of motion (ROMs) were: flexion 131.5° (124.2° to 138.8°), extension 29.3° (26.8° to 31.9°), pronation 74.0° (67.8° to 80.2°), and supination 72.5° (69.5° to 75.5°), and the mean postoperative Mayo Elbow Performance Score (MEPS) was 89.3 (95% CI 86.9 to 91.6). The meta-regression analysis identified that younger patients and implants with an unlinked design correlated with higher failure rates. Younger patients were associated with increased complications, while female patients and an unlinked prosthesis were associated with aseptic loosening. Conclusion TEA continues to provide satisfactory results for patients with RA. However, it is associated with a substantially higher implant failure and complication rates compared with hip and knee arthroplasties. The patient’s age, sex, and whether cemented fixation and unlinked prosthesis were used can influence the outcome. Level of Evidence: Therapeutic Level IV. Cite this article: Bone Joint J 2020;102-B(8):967–980.

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