Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study

Hanim, Nor; Teh, Cheng Lay; Rapaee, Annuar; Lau, Kim Bee; Fong, Alan Yean Yip; Hi, Sithy; Chang, Boon Cheng; Yew, Kuan Leong; Liew, Houng Bang; Ang, Choon Kiat; Ong, T.K.; Chua, Seng Keong; Chin, Rowland Wee Ming; Sim, Kui Hian

doi:10.1111/j.1756-185x.2010.01533.x

Cited by 7 publications

(5 citation statements)

References 26 publications

(46 reference statements)

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“…Ma, et al 46 reported that patients with RA who have active disease with longer disease duration have increased risk of cardiovascular events compared to the normal population, a finding that coincides with our previous ones. Meanwhile, Hosseinsabet, et al 47 found no correlation between CRP and CCS.…”

Section: Discussionsupporting

confidence: 90%

Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis

Abdel-Khalek¹,

El-Barbary²,

Essa³

et al. 2011

J Rheumatol

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Section: Discussionsupporting

confidence: 90%

Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis

Abdel-Khalek¹,

El-Barbary²,

Essa³

et al. 2011

J Rheumatol

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“…An earlier study investigated the presence of obstructive CAD in 47 patients with RA in stable remission using CTA 49. Incidence rates were similar to ours (19.1% for RA and 6.4% for controls versus 12% and 3%, respectively, in ours).…”

Section: Discussionsupporting

confidence: 85%

Prevalence, extent and composition of coronary plaque in patients with rheumatoid arthritis without symptoms or prior diagnosis of coronary artery disease

et al. 2013

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“…could demonstrate a reduction of IMT in RA patients, associated with a decrease in disease activity [45]. Also, in RA patients in remission (DAS-28 score below 2.60) with an average disease duration of three years, coronary artery disease was not increased compared to controls [51]. Secondly, discrepancies in IMT results might be explained by patient selection.…”

Section: Discussionmentioning

confidence: 99%

Advanced glycation endproducts are increased in rheumatoid arthritis patients with controlled disease

et al. 2011

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IntroductionAdvanced glycation end products (AGEs) are produced and can accumulate during chronic inflammation, as might be present in patients with rheumatoid arthritis (RA). AGEs are involved in the development of cardiovascular disease. The aim of this study is to evaluate whether AGEs are increased in patients with long-standing RA and whether AGE accumulation is related to disease activity, disease severity and measures of (premature) atherosclerosis, such as endothelial activation, endothelial dysfunction and intima media thickness (IMT).MethodsIn a cross-sectional study, 49 consecutive RA patients with longstanding disease (median disease duration of 12.3 years (range 9.3 to 15.1)), receiving standard of care, were included and compared with 49 age- and sex-matched healthy controls (HC). AGEs were determined by skin autofluorescence. Disease activity was evaluated by the Disease Activity Score of 28 joints (DAS-28) score and joint damage by modified Sharp-v.d. Heijde score. Endothelial activation (soluble vascular cellular adhesion molecule-1) sVCAM-1, von Willebrand factor (vWF), thrombomodulin), endothelial dysfunction (determined by small artery elasticity (SAE)) and IMT were measured and related to AGE accumulation.ResultsAGEs were increased in RA patients (median 2.4 arbitrary units (a.u.), range 1.6 to 4.2) compared to HC (2.2, 1.3 to 3.8). RA patients had a DAS-28 score of 2.9 (0.8 to 6.9) and a modified Sharp-v.d. Heijde score of 19 (0 to 103). sVCAM-1 and vWF levels were higher in RA patients. SAE was significantly decreased in RA (3.9 ml/mmHg (1.4 to 12.2) vs. 6.1 in HC (1.7 to 12.9). IMT did not differ between the two groups. Combining both groups' AGEs correlated with vWF, sVCAM-1 and IMT, and was inversely related to SAE. In RA, AGEs had an inverse relation with SAE, but did not relate to disease activity or radiological damage. In multivariate analysis for both groups, smoking, glucose levels, vWF, SAE and male gender were significantly related to the formation of AGEs.ConclusionsAGEs were increased in RA patients with long-standing disease and without signs of premature atherosclerosis. AGEs were related to endothelial activation and endothelial dysfunction. This supports the hypothesis that in RA AGEs may be an early marker of cardiovascular disease.

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Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study

Abstract: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.

Cited by 7 publications

References 26 publications

Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis

Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis

Prevalence, extent and composition of coronary plaque in patients with rheumatoid arthritis without symptoms or prior diagnosis of coronary artery disease

Advanced glycation endproducts are increased in rheumatoid arthritis patients with controlled disease

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