Clinical relevance of peripheral vascular occlusive disease in patients with rheumatoid arthritis and systemic lupus erythematosus 11Competition of interest: none.

Henke, Peter K.; Sukheepod, Pasu; Proctor, Mary C.; Upchurch, Gilbert R.; Stanley, James C.

doi:10.1016/s0741-5214(03)00074-0

Cited by 15 publications

(14 citation statements)

References 26 publications

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“…[65][66][67][68][69] Indeed, despite a clear distinction in their pathophysiology, rheumatoid arthritis and systemic lupus erythematosus share an inflammatory process that is strikingly similar to the process leading to atherosclerosis. 70 Unfortunately, however, most studies investigating the association of rheumatoid arthritis and systemic lupus erythematosus with PAD are small and cross-sectional.…”

Section: Autoimmune Disease and Pad Riskmentioning

confidence: 99%

Inflammation in Peripheral Artery Disease

et al. 2010

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Section: Autoimmune Disease and Pad Riskmentioning

confidence: 99%

Inflammation in Peripheral Artery Disease

et al. 2010

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“…In fact, several cases of peripheral vascular disease causing chronic leg ulcers in rheumatoid patients have been reported, in some cases even leading to limb amputation. [14][15][16] Our findings suggest that impairment of peripheral arterial function in rheumatoid arthritis may be more common than previously suspected.…”

Section: Discussionmentioning

confidence: 47%

“…Indeed, cases of severe peripheral vascular disease affecting rheumatoid patients have been described. [14][15][16] However, the frequency and extent of impaired peripheral arterial function in rheumatoid arthritis are not well established. This information is important for an understanding of atherosclerosis and cardiovascular disease in general, and of how such disorders affect patients with rheumatoid arthritis.…”

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confidence: 99%

Lower limb arterial incompressibility and obstruction in rheumatoid arthritis

Rincón

Haas

Pogosian

et al. 2004

Annals of the Rheumatic Diseases

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Background: Despite increased cardiovascular morbidity and mortality in rheumatoid arthritis, the peripheral arteries remain understudied. Objective: To examine the lower limb arteries in age and sex matched, non-smoking subjects with and without rheumatoid arthritis. Methods: The ankle-brachial index (ABI) was measured at the posterior tibial and dorsal pedal arteries. Arteries were classified as obstructed with ABI (0.9, normal with ABI .0.9 but (1.3, and incompressible with ABI .1.3. Multinomial logistic regression was used to estimate differences in ABI between patients and controls, adjusting for cardiovascular risk factors, rheumatoid arthritis manifestations, inflammation markers, and glucocorticoid dose. Results: 234 patients with rheumatoid arthritis and 102 controls were studied. Among the rheumatoid patients, 66 of 931 arteries (7%) were incompressible and 30 (3%) were obstructed. Among the controls, three of 408 arteries (0.7%) were incompressible (p = 0.002) and four (1%) were obstructed (p = 0.06). At the person level, one or more abnormal arteries occurred among 45 rheumatoid patients (19%), v five controls (5%, p = 0.001). The greater frequency of arterial incompressibility and obstruction in rheumatoid arthritis was independent of age, sex, and cardiovascular risk factors. Adjustment for inflammation markers, joint damage, rheumatoid factor, and glucocorticoid use reduced rheumatoid arthritis v control differences. Most arterial impairments occurred in rheumatoid patients with 20 or more deformed joints. This subgroup had more incompressible (15%, p(0.001) and obstructed arteries (6%, p = 0.005) than the controls, independent of covariates. Conclusions: Peripheral arterial incompressibility and obstruction are increased in rheumatoid arthritis. Their propensity for patients with advanced joint damage suggests shared pathogenic mechanisms.

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“…We excluded studies published only in abstract form, non‐human studies, cardiac surgical studies, paediatric studies and in‐vitro or non‐operative human studies. We also excluded studies where the patients were known to be complicated by infection [10–12] or chronic inflammation [13, 14].…”

Section: Methodsmentioning

confidence: 99%

A meta‐analysis of the utility of C‐reactive protein in predicting early, intermediate‐term and long term mortality and major adverse cardiac events in vascular surgical patients

Padayachee¹,

Rodseth²,

Biccard

2009

Anaesthesia

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SummaryWe conducted a meta-analysis of the utility of pre-operative C reactive protein (CRP) in predicting early (< 30 days), intermediate (30-180 days) and long term (> 180 days) mortality and major adverse cardiac events (MACE; cardiac mortality and nonfatal myocardial infarction (MI) combined) following vascular surgery. Of 291 studies identified, ten prospective patient cohorts were identified. A pre-operative CRP > 3 mg. Vascular surgery is associated with major adverse perioperative cardiac events. Unfortunately, currently used pre-operative diagnostic tests for these patients are not statistically robust enough to accurately predict these events [1]. A meta-analysis of six pre-operative tests for vascular surgical patients which included; ambulatory ECG, exercise ECG, radionuclide ventriculography, myocardial perfusion scintigraphy, dipyridamole stress echocardiography and dobutamine stress echocardiography, showed that dobutamine stress echocardiography had a trend to the best performance of the six tests for the prediction of major adverse cardiac events (MACE; defined as peri-operative cardiac death and non-fatal myocardial infarction (MI) within 30 days of surgery [2]), with a positive likelihood ratio (LR) and negative LR of 2.8 and 0.21 respectively. As statistically, good discrimination requires a LR of > 10 and < 0.2, there are clearly clinical limitations to the utility of these pre-operative tests for vascular surgical patients [1].

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Clinical relevance of peripheral vascular occlusive disease in patients with rheumatoid arthritis and systemic lupus erythematosus 11Competition of interest: none.

Abstract: Patients with RD should receive treatment on the basis of standard criteria for limb ischemia, in that surgical revascularization outcomes are satisfactory. Immunosuppressive agents may confer a protective effect against progression of PVOD.

Cited by 15 publications

References 26 publications

Inflammation in Peripheral Artery Disease

Inflammation in Peripheral Artery Disease

Lower limb arterial incompressibility and obstruction in rheumatoid arthritis

A meta‐analysis of the utility of C‐reactive protein in predicting early, intermediate‐term and long term mortality and major adverse cardiac events in vascular surgical patients

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