Cardiovascular risk score in Rheumatoid Arthritis

Wagan, Abrar Ahmed; Mahmud, T.; Rasheed, Aflak; Zafar, Zafar Ali; Rehman, Ata Ur; Ali, Amjad

doi:10.12669/pjms.323.9779

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…In the present study, the mean age of the patients with RA was 45.3 ± 11.5 years. Our results align with that of Wagan et al (2016), who reported a similar mean age of 45.1±9.5 years among patients with RA at Sheikh Zayed Federal Post Graduate Medical Institute, Lahore, Pakistan [16]. Imran et al…”

Section: Discussionsupporting

confidence: 91%

Frequency of Interstitial Lung Disease in Rheumatoid Arthritis Patients: A Hospital-Based Study

Iqbal¹,

Khan²,

Hassan³

et al. 2022

Cureus

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Introduction: Among various extra-articular manifestations of rheumatoid arthritis (RA), interstitial lung disease (ILD) is the most frequent and concerning manifestation. The reported frequency of RA-associated ILD (RA-ILD) varies in the literature. The objective of the present study was to determine the frequency of ILD in RA patients at a teaching hospital in Rawalpindi.Methods: 175 male and female patients between 18-70 years were enrolled in the study from January 21, 2022, till July 24, 2022. Patients diagnosed with RA were screened for the concomitant presence of ILD (increased pulmonary markings on chest X-rays and total lung capacity ≤ 80%, predicted on pulmonary function tests). In addition, the frequency of RA-ILD was noted and compared across various subgroups of patients based on age, gender, and disease duration.Results: The mean age of the patients was 45.3 ± 11.5 years. The male-to-female ratio was 1:3.1. The mean disease duration was 6.2 ± 3.5 years at the time of presentation. A total of 118 (67.4%) patients were diagnosed with RA-ILD. The frequency of RA-ILD was significantly higher among patients with a prolonged duration of disease, < 5 years vs. ≥ 5 years (59.1% vs. 75.9%; p-value=0.018). Among 118 patients with RA-ILD, usual interstitial pneumonia (UIP) was the most frequent pattern and was noted in 74 (62.7%) patients, followed by nonspecific interstitial pneumonitis (NSIP), which was noted in 44 (37.3%) patients. When compared, there was no statistically significant difference in the frequency of high-resolution CT (HRCT) pattern of RA-ILD across various subgroups of patients based on age (p-value=0.969), gender (p-value=0.934), and duration of disease (p-value=0.881). Conclusion:In the present study, a substantial proportion of RA patients suffered RA-ILD, which warrants routine screening of these patients for undiagnosed pulmonary involvement so that timely identification and anticipated management may improve the outcome of such cases in future clinical practice.

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Section: Discussionsupporting

confidence: 91%

Frequency of Interstitial Lung Disease in Rheumatoid Arthritis Patients: A Hospital-Based Study

Iqbal¹,

Khan²,

Hassan³

et al. 2022

Cureus

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“…The QRISK-2 scores were also positively correlated with plasma L5% or L5 levels, whereas Framingham score were not. This discrepancy may be explained by the more inclusive calculation design of QRISK-2 scoring, additionally enrolling RA disease, ethnicity, chronic kidney disease, and atrial fibrillation as factors in the risk assessment [28,40]. During the follow-up period of more 2 years, CVD developed in three RA patients, all who had carotid atherosclerosis and markedly higher L5% (22.1%, 9.8%, and 7.5%) and L5 levels (21.9 mg/dL, 10.8 mg/dL, and 12.5 mg/dL) than did patients who did not have a CVD event.…”

Section: Discussionmentioning

confidence: 99%

Association between Negatively Charged Low-Density Lipoprotein L5 and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients

Chang

Chen

et al. 2019

JCM

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L5, the most negatively charged subfraction of low-density lipoprotein (LDL), is implicated in atherogenesis. We examined the relationship between plasma L5 levels and the occurrence of subclinical atherosclerosis in patients with rheumatoid arthritis (RA). Using anion-exchange purification with fast-protein liquid chromatography, we determined the proportion of plasma L5 of LDL (L5%) in 64 RA patients and 12 healthy controls (HC). Plasma L5% and L5 levels were significantly higher in RA patients (median, 1.4% and 1.92 mg/dL) compared with HC (0.9%, p < 0.005; and 1.27 mg/dL, p < 0.05) and further increased in patients with subclinical atherosclerosis (2.0% and 2.88 mg/dL). L5% and L5 levels decreased in patients after 6-months of therapy (p < 0.01). Subclinical atherosclerosis was indicated by plaque and intima-media thickness determined by carotid ultrasonography. Using multivariate analysis, L5% and L5 levels are revealed as the predictors of subclinical atherosclerosis (odds ratio, 4.94 and 1.01; both p < 0.05). Receiver operating characteristic curves showed that cut-off values of L5% ≥ 1.45% and L5 levels ≥ 2.58 mg/dL could predict subclinical atherosclerosis in patients (both p < 0.001). Immunoblotting showed that the expression levels of lectin-like oxidized LDL receptor-1 (LOX-1) was increased in RA patients. Together, our findings suggest that plasma L5% and L5 levels may be predictors of cardiovascular risk in RA patients.

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“…RA leads not only to the destruction of cartilage and bone but also to system damage including cardiovascular, pulmonary, and endocrine system [ 27 , 28 ]. This demonstrated a relationship between inflammatory factors and insulin resistance [ 29 – 31 ].…”

Section: Inflammation and Abnormal Glucose Metabolismmentioning

confidence: 99%

Abnormal Glucose Metabolism in Rheumatoid Arthritis

Zhou

Jin

et al. 2017

BioMed Research International

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The incidence of abnormal glucose metabolism in patients with rheumatoid arthritis was considerably higher than the general population. The persistent systemic inflammatory state in rheumatoid arthritis might be associated with the glucose metabolism dysfunction. In this context, insulin resistance, islet β cell apoptosis, inflammatory cytokines, and other aspects which were linked with abnormal glucose metabolism in rheumatoid arthritis were reviewed. This review will be helpful in understanding the abnormal glucose metabolism mechanism in patients with rheumatoid arthritis and might be conducive to finding an effective treatment.

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Cardiovascular risk score in Rheumatoid Arthritis

Cited by 7 publications

References 15 publications

Frequency of Interstitial Lung Disease in Rheumatoid Arthritis Patients: A Hospital-Based Study

Frequency of Interstitial Lung Disease in Rheumatoid Arthritis Patients: A Hospital-Based Study

Association between Negatively Charged Low-Density Lipoprotein L5 and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients

Abnormal Glucose Metabolism in Rheumatoid Arthritis

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