Clinical and demographic features of cardio-vascular risk in female with rheumatoid arthritis according to mSCORE analysis results

Authors

  • O. O. Garmish Strazhesko Institute of Cardiology, Kyiv,
  • V. G. Levchenko Strazhesko Institute of Cardiology, Kyiv,
  • O. I. Mitchenko Strazhesko Institute of Cardiology, Kyiv,

DOI:

https://doi.org/10.14739/2310-1210.2016.6.85483

Keywords:

rheumatoid arthritis, cardiovascular risk factors, cholesterol total, HDL, LDL, triglycerides, apolipoprotein AI, apolipoprotein В, uric acid, ACE, microalbuminuria, immunobiological therapy, mSCORE, DAS28, NPJ, NSJ

Abstract

The aim of the research was to estimate the occurrence of cardio-vascular risk among patients with rheumatoid arthritis depending on age, status of menopause, dyslipidemia and clinical and laboratory features.

Materials and methods. 50 female patients with confirmed diagnosis of rheumatoid arthritis were examined. Cardio-vascular risk was defined according to mSCORE with the following gradation: low, middle, high, very high level among women aged >45 years old. Laboratory diagnostics consisted of clinical and biochemistry blood analysis, determination of CRP, RF and ACCP. DAS28 was used for activity characteristic. Cholesterol, HDL, LDL, thyroglobulin, apoliprotein A1, apoliproteinB, uric acid, ATE, microalbuminuria were tested.

Results. Estimation of cardio-vascular risk occurrence among patients older than 45 years old showed that the majority had a middle level of cardio-vascular risk whereas almost every fifth patient has a high level. Analysis of cardio-vascular risk occurrence according to mSCORE depending on patients’ age showed its significant elevation among patients elder than 45 years old and substantial differences in quantitative indices in group of patients aged 46 - 60 and >60. 83.3 % of reproductive age female patients did not show cardio-vascular risk, 11.1 % showed middle level and 5.6 % - low level of cardio-vascular risk. Only 3.9 % of postmenopausal women did not have a cardio-vascular risk, the majority (64.7 %) showed middle level, 25.5 % – high level and 3.9 % – very high level. The analysis revealed the presence of significant differences in patients older than 60 years old and the most of them demonstrated cardio-vascular risk more than 5 %. The majority of patients, who received immunobiological therapy (methotrexat), had cardio-vascular risk less than 5 %.

Conclusions. Occurrence of cardio-vascular risk among women older than 45 years old with rheumatoid arthritis made 96% whereas its grater part was registered in patients older than 60 years old. Significantly higher quantitative indices of cardio-vascular risk according to mSCORE scale were observed in patients with high activity level of inflammatory process (CRP, TJC, SJC and DAS28 levels). Analysis of cardio-vascular risk occurrence indicated its increasing trend among women who did not receive immunobiological therapy. The tested group of patients with cardio-vascular risk of more than 5% showed dyslipidemia which was characterized by higher levels of cholesterol, LDL, apoliproteinB and significantly lower HDL concentration.

References

Gonzalez-Gay, M. A., Gonzalez-Juanatey, C., & Martin, J. (2005) Rheumatoid arthritis: a disease associated with accelerated atherogenesis. Semin Arhtritis Rheum, 35, 8–17. doi: http://dx.doi.org/10.1016/j.semarthrit.2005.03.004.

Dessein, P. H., Joffe, B. I., Veller, M. G., Stevens, B.A., Tobias, M., Reddi, K., & Stanwix, A. E. (2005) Traditional and nontraditional cardrisk factors are associated with atherosclerosis in rheumatoid arthritis. J Rheumatol, 32, 435–42.

Gonzalez-Gay, M. A., Gonzalez-Juanatey, C., Lopez-Diaz, M. J., Piñeiro, A., Garcia-Porrua, C., Miranda-Filloy, J. A., et al. (2007) HLA-DRB1 persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rh, 57, 125–32. doi: 10.1002/art.22482.

Rodríguez-Rodríguez, L., González-Juanatey, C., Palomino-Morales, R., Vázquez-Rodríguez, T. R., Miranda-Filloy, J. A., Fernández-Gutiérrez, B., et al. (2011) TNFA -308 (rs1800629) polymorphism is associated with a higher risk of cardiovascular disease in patients with rheumatoid arthritis. Atherosclerosis, 216, 125–30. doi: 10.1016/j.atherosclerosis.2010.10.052.

Hippisley-Cox, J., Coupland, C., Vinogradova, Y., Robson, J., Minhas, R., Sheikh, A., & Brindle, P. (2008) Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ, 336, 1475–82. doi: http://dx.doi.org/10.1136/bmj.39609.449676.25.

Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Z., Verschuren, M., et al. (2012) European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J., 33(13), 1635–701. doi: 10.1093/eurheartj/ehs092.

Peters, M. J., Symmons, D. P., McCarey, D., Dijkmans, B. A., Nicola, P., Kvien, T. K., et al. (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis, 69, 325–31. doi: 10.1136/ard.2009.113696.

Corrales, A., Parra, J. A., Gonzalez-Juanatey, C., Rueda-Gotor, J., Blanco, R., Llorca, J., & González-Gay, M. A. (2013) Cardiovascular risk stratification in rheumatic diseases: carotid ultrasound is more sensitive than Coronary Artery Calcification Score to detect subclinical atherosclerosis in patients with rheumatoid arthritis. Ann Rheum Dis, 72, 1764–70. doi: 10.1136/annrheumdis-2013-203688.

Semb, A. G., Kvien, T. K., Aastveit, A. H., Jungner, I., Pedersen, T. R., Walldius, G., & Holme, I. (2010) Lipids, myocardial infarction and ischaemic stroke in patients with rheumatoid arthritis in the Apolipoprotein-related Mortality RISk (AMORIS) Study. Ann Rheum Dis, 69, 1996–2001. doi: 10.1136/ard.2009.126128.

Myasoedova, E., Crowson, C. S., Kremers, H. M., Roger, V. L., Fitz-Gibbon, P. D., Therneau, T. M., & Gabriel, S. E. (2011) Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. Ann Rheum Dis, 70, 482–7. doi: 10.1136/ard.2010.135871.

How to Cite

1.
Garmish OO, Levchenko VG, Mitchenko OI. Clinical and demographic features of cardio-vascular risk in female with rheumatoid arthritis according to mSCORE analysis results. Zaporozhye Medical Journal [Internet]. 2016Dec.8 [cited 2024Nov.2];18(6). Available from: http://zmj.zsmu.edu.ua/article/view/85483

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Section

Original research