Risk Factors Associated with Different Stages of Atherosclerosis in Colombian Patients with Rheumatoid Arthritis
pmid: 18395773
Risk Factors Associated with Different Stages of Atherosclerosis in Colombian Patients with Rheumatoid Arthritis
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.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 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.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.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.
- Universidad de San Buenaventura, Bogota Colombia
- National University of Colombia Colombia
- Pontificia Universidad Javeriana Colombia
Adult, Carotid Artery Diseases, Male, Arthritis, Colombia, Middle Aged, Risk Assessment, Severity of Illness Index, Arthritis, Rheumatoid, Rheumatoid Factor, Risk Factors, Rheumatoid, Vascular, Humans, Female, Endothelium, Endothelium, Vascular, Tunica Intima, Tunica Media, Ultrasonography
Adult, Carotid Artery Diseases, Male, Arthritis, Colombia, Middle Aged, Risk Assessment, Severity of Illness Index, Arthritis, Rheumatoid, Rheumatoid Factor, Risk Factors, Rheumatoid, Vascular, Humans, Female, Endothelium, Endothelium, Vascular, Tunica Intima, Tunica Media, Ultrasonography
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