Inflammatory burden interacts with conventional cardiovascular risk factors for carotid plaque formation in rheumatoid arthritis

Im, Churl Hyun; Kim, Na Ri; Kang, Jieun; Kim, Ji Hun; Kang, Jin Young; Bae, Gi Bum; Nam, Eon Jeong; Kang, Young Mo

doi:10.1093/rheumatology/keu376

Cited by 48 publications

(52 citation statements)

References 38 publications

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“…25,26 Patients with RA also have elevated C-reactive protein (CRP), a classical marker of inflammation that is often associated with CV risk. 8,20,21 This is in line with present study finding wherein 42.5% of RA patients had elevated CRP. Apart from this elevated ESR levels, which reflect cumulative inflammatory burden be independently associated with carotid plaque thickness, even suggesting a synergistic interaction with traditional CV risk factors.…”

Section: Discussionsupporting

confidence: 90%

“…Apart from this elevated ESR levels, which reflect cumulative inflammatory burden be independently associated with carotid plaque thickness, even suggesting a synergistic interaction with traditional CV risk factors. 20,27 One of the limitations of present study, which is inherent to non-longitudinal studies is that the inflammation markers measured at a single point of time may fail to be associated with cIMT. 28 There are two possible explanations for this.…”

Section: Discussionmentioning

confidence: 90%

“…I'm et al, and Kisiel et al, reported similar findings stating that the mean cIMT and carotid plaque thickness was higher among RA patients than in controls. 20,21 Considerable epidemiological and clinical evidence have been showing that accelerated atherosclerosis may be one of the key aspects of RA. 2,4,22 The clinical significance of such findings can be understood when authors consider that the risk of myocardial infarction increases by up to 43% for every 0.163mm increase in cIMT.…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

Joena

2019

Int J Adv Med

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Background: IMT assessment as a non-invasive imaging test is quite widely used especially among RA patients, the clinical applications of using such knowledge is scarce, hence study was conducted to compare the carotid artery intima-media thickness (CIMT) in patients with rheumatoid arthritis (RA) with healthy controls also to study the correlation between duration of rheumatoid arthritis, the activity of rheumatoid arthritis and other factors influencing (CIMT).Methods: In analytical cross-sectional study, of 80 participants of RA and 40 healthy controls, “DAS28” was used to assess disease activity. Carotid intima-media thickness assessed using carotid ultrasonography.Results: Mean age of the cases and controls was 43.9 and 44.38 years. Subjects with duration of disease <2 years, to 5 years and >5 years were 35%, 45% and 20%. The mean carotid intima-media thickness was 5.61mm in controls, and CIMT was 6.11mm in people below 2 years and 7.08 mm in people between 2 to 5 years and 8.00mm in people above 5 years which was statistically significant. The mean carotid intima-media thickness was 5.61mm controls and 6.86mm in people with low, 7.00mm in people with moderate and 6.95mm in people with high disease activity, which was statistically significant.Conclusions: Study findings revealed risk of increase in carotid intima-media thickness higher among RA patients in the later stages and can increase the patients’ susceptibility to cardiovascular events. The factors showing strong association with intimal medial thickness were the age and symptoms duration.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

Joena

2019

Int J Adv Med

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“…Patients with RA have increased rates of cardiovascular (CV) morbidity and mortality due to accelerated formation of atherosclerotic lesions that are more prone to rupture . This elevated CV risk is associated with traditional cardiological risk factors and with the presence of systemic inflammation, which may promote atherosclerosis . Hydroxychloroquine (HCQ), a weak basic 4‐aminoquinoline compound, can improve the survival rates of patients with some inflammatory diseases, including RA .…”

Section: Introductionmentioning

confidence: 99%

Protective effect of hydroxychloroquine on rheumatoid arthritis‐associated atherosclerosis

Shi

Zhang

Silverman

et al. 2019

Anim Models and Exp Med

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Background Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease. We examined the effect of gut microbiota in a mouse model of RA that develops atherosclerosis. Methods We created three groups of K/BxN female mice that were positive for the anti‐glucose‐6‐phosphate isomerase (GPI) antibody: control diet (CD), high fat diet (HFD), and HFD with hydroxychloroquine (HFD + HCQ). Serological tests were used to detect the serum levels of total cholesterol (TCHO), low‐density lipoprotein cholesterol (LDL‐C), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐C), anti‐GPI antibody titers, and serum cytokines. Atherosclerotic plaque was determined by histological analysis, and gut microbiota were determined by 16sV4 sequencing. Results Relative to mice given the CD, those receiving the HFD had increased serum levels of LDL‐C, TCHO, and TG, decreased serum levels of HDL‐C, increased atherosclerotic lesions in the aortic root, and altered gut microbiota. Addition of HCQ to HFD decreased the serum levels of LDL‐C, TCHO, and TG, increased serum levels of HDL‐C, and decreased the atherosclerotic lesions in the aortic root. Mice receiving HFD + HCQ also had the greatest bacterial diversity among the three experimental groups. Moreover, HCQ treatment significantly increased the abundance of Akkermansia and Parabacteroides , and decreased the abundance of Clostridium sensu stricto cluster 1, and therefore may be responsible for the reduced RA‐associated atherosclerosis and dyslipidemia. Conclusion Our mouse model of RA indicated that HFD increased ankle width and aggravated atherosclerosis and dyslipidemia, and that HCQ alleviated the dyslipidemia and atherosclerosis, but had no effect on ankle width.

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“…Moreover, the systemic inflammation caused by RA is an important independent risk factor for cardiovascular disease, and the cardiovascular risk components also increase the inflammatory burden of RA (13,14). The clinical features of RA include pain, joint swelling, stiffness, weakness at local lesions, deformity, erythema and weight loss.…”

Section: Parasitic Infection As a Potential Therapeutic Tool Against mentioning

confidence: 99%

Parasitic infection as a potential therapeutic tool against rheumatoid arthritis

Apaer

Tuxun

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Parasites, which are a recently discovered yet ancient dweller in human hosts, remain a great public health burden in underdeveloped countries, despite preventative efforts. Rheumatoid arthritis is a predominantly cosmopolitan health problem with drastic morbidity rates, although encouraging progress has been achieved regarding treatment. However, although various types of methods and agents have been applied clinically, their broad usage has been limited by their adverse effects and/or high costs. Sustained efforts have been exerted on the 'hygiene hypothesis' since the 1870s. The immunosuppressive nature of parasitic infections may offer potential insight into therapeutic strategies for rheumatoid arthritis, in which the immune system is overactivated. An increasing number of published papers are focusing on the preventive and/or curative effect of various parasitic infection on rheumatoid arthritis from experimental studies to large-scale epidemiological studies and clinical trials. Therefore, the present review aimed to provide a general literature review on the possible beneficial role of parasitic infection on rheumatoid arthritis.

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Inflammatory burden interacts with conventional cardiovascular risk factors for carotid plaque formation in rheumatoid arthritis

Abstract: Cumulative inflammatory burden contributes to the development of carotid atherosclerosis through a synergistic interaction with conventional CV risk factors in patients with RA.

Cited by 48 publications

References 38 publications

Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

Factors affecting carotid intimal medial thickness in patients with rheumatoid arthritis, an analytical cross-sectional study

Protective effect of hydroxychloroquine on rheumatoid arthritis‐associated atherosclerosis

Parasitic infection as a potential therapeutic tool against rheumatoid arthritis

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