Effect of rheumatoid arthritis or systemic lupus erythematosus on the risk of First-Time acute myocardial infarction

Fischer, Lorenz; Schlienger, Raymond G.; Matter, Christian M.; Jick, Hershel; Meier, Christoph

doi:10.1016/j.amjcard.2003.09.037

Cited by 202 publications

(139 citation statements)

References 15 publications

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“…Because RA patients with active disease have a high propensity to suffer from cardiovascular disorders, especially myocardial infarction, 34 and because EPC levels are correlated inversely with cardiovascular risk factors, 26 our findings support these associations. Importantly, patients with low disease activity had normal EPC levels, in line with indications of reduced cardiovascular mortality among patients treated effectively with DMARDs 7 and with the very recent finding of EPC inhibition by CRP.…”

Section: Discussionsupporting

confidence: 79%

Depletion of Endothelial Progenitor Cells in the Peripheral Blood of Patients With Rheumatoid Arthritis

et al. 2005

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Background-Rheumatoid arthritis (RA) is characterized by increased cardiovascular morbidity and mortality that cannot be explained solely by traditional cardiovascular risk factors. Cardiovascular morbidity is related to disease activity and can be normalized by effective therapy. Because the quantity of endothelial progenitor cells (EPCs) in the peripheral blood is correlated inversely with cardiovascular risk, we studied whether such abnormalities could also be observed in patients with RA. Methods and Results-EPCs were determined in 52 RA patients and in 16 healthy referents (HRs) by fluorescence-activated cell-sorting (FACS) analysis. Patients were divided into groups characterized by active disease (nϭ36) and low disease activity (nϭ16). Cells that were positive by flow cytometry for CD34/KDR/AC133 within the lymphocyte population were characterized as EPCs. Furthermore, in subgroups of patients, circulating EPCs were also quantified by a colony-forming unit (CFU) and a circulating angiogenic cell (CAC) assay.

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Section: Discussionsupporting

confidence: 79%

Depletion of Endothelial Progenitor Cells in the Peripheral Blood of Patients With Rheumatoid Arthritis

et al. 2005

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“…The risk appears to accumulate over time and persists after adjustment for other cardiovascular risk factors (relative risk of MI is greater than three after 10 years of having the disease) [6,12] suggesting that RA independently doubles the hazard for myocardial infarction and sudden cardiac death. The degree of increased risk of myocardial infarction in SLE patients varies, with risks as high as 50-fold in premenopausal women and decreasing to the risk of the general population in the elderly [13][14][15]. The nurses' health study found a slightly greater than twofold risk of cardiovascular disease in lupus patients [16].…”

Section: Introductionmentioning

confidence: 99%

Lack of cardiovascular risk assessment in inflammatory arthritis and systemic lupus erythematosus patients at a tertiary care center

2011

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The purpose of this study is to evaluate cardiovascular risk assessment at a Canadian rheumatology center and describe the cardiovascular risk of inflammatory arthritis (IA) and systemic lupus erythematosus (SLE) patients using the Framingham risk score. A retrospective chart review of 504 patients attending nine rheumatology practices at the University of Alberta Hospital was performed. A pre-specified case report form detailed patient demographics, cardiac risk factors, variables for the Framingham 2008 score, disease activity, and medication use. In this group of 504 patients, 64 (12.7%) had SLE (male (M) to female (F) ratio=60:4) and 440 (87.3%) had an IA (M to F ratio=117:323). Of the SLE patients, 31 (48.4%) met four or more American College of Rheumatology (ACR) criteria, 33 (51.6%) had less than four ACR criteria. Of the IA patients, 156 (35.5%) were CCP positive and 257 (58.4%) were RF positive. Utilizing the chart data, retrospective Framingham risk scores were calculable for one (1.6%) SLE patient and three (0.68%) IA patients. The most common cardiac risk factors not documented in the medical records of both the SLE and IA patients included: (1) positive family history of MI, (2) diabetes, and (3) lipid status. The blood pressure was more frequently documented in the SLE patients (93.8%) compared to the IA patients (56.1%). While traditional cardiac risk factors only partially contribute to the increased cardiovascular risk in these patients, cardiovascular risk assessment was suboptimally performed amongst a large group of rheumatologists. A dedicated cardiovascular risk reduction clinic for inflammatory rheumatic diseases has been established at this site to fulfill this need and evaluate treatment strategies.

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“…There is evidence of increased carotid intima-media thickness (IMT) in young long-term RA patients receiving standard methotrexate (MTX) therapy (1) and of high rates of myocardial infarction in women affected by RA in the absence of overt clinical atherosclerosis (2)(3)(4). The accelerated atherosclerosis found in these patients is not easily explained by traditional risk factors, suggesting that a systemic inflammatory response in RA may play a role in atherogenesis and/or in accentuating established atherosclerotic risk factors (5).…”

Section: Introductionmentioning

confidence: 99%

Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima–media thickness in female patients with active rheumatoid arthritis

et al. 2009

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Effect of rheumatoid arthritis or systemic lupus erythematosus on the risk of First-Time acute myocardial infarction

Cited by 202 publications

References 15 publications

Depletion of Endothelial Progenitor Cells in the Peripheral Blood of Patients With Rheumatoid Arthritis

Depletion of Endothelial Progenitor Cells in the Peripheral Blood of Patients With Rheumatoid Arthritis

Lack of cardiovascular risk assessment in inflammatory arthritis and systemic lupus erythematosus patients at a tertiary care center

Long-term anti-tumour necrosis factor therapy reverses the progression of carotid intima–media thickness in female patients with active rheumatoid arthritis

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