The count of tender rather than swollen joints correlates with aortic stiffness in patients with rheumatoid arthritis

Abstract

BackgroundPatients with rheumatoid arthritis (RA) are at a higher cardiovascular (CV) risk in comparison to the general population. CV risk associates closely with aortic stiffness. Aim of this exploration was therefore to evaluate aortic stiffness in patients with RA and to examine its association with various RA associated parameters as well as with traditional CV risk factors.MethodsMeasurements of carotid-femoral pulse wave velocity (cfPWV) were analyzed retrospectively in 38 RA patients and 25 controls. We investigated the statistical difference between cfPWV values in the two groups. Furthermore, we analyzed the associations of cfPWV with laboratory and clinical RA parameters including Disease Activity Score 28 and its components, rheumatoid factor, cyclic citrullinated peptide antibodies, antinuclear antibodies and RA duration. Finally, we explored the relationship of cfPWV with traditional CV risk factors in the RA group.ResultscfPWV was not significantly higher in RA patients in comparison to controls in an adjusted statistical model for confounding factors [−0.587 95 % CI (−1.38 to 0.201), p = 0.144]. Among RA patients there was a statistically significant correlation of cfPWV with age (rho = 0.544, p = 0.001) and the count of tender joints [0.051 95 % CI (0.008–0.207), p = 0.034]. Finally, C-reactive protein associated only marginally with cfPWV [0.105 95 % CI (−0.410 to 0.003), p = 0.053].ConclusionsIn RA patients the number of tender, rather than swollen joints correlates with stiffness of the aorta, as measured through cfPWV. Therefore, RA associated joint pain might play a role in the development of aortic stiffness and thus increase CV risk.

Characteristics and clinical associations of arterial stiffness and subclinical atherosclerosis in patients with rheumatoid arthritis

“…Эпидемиологические исследования дают основания считать, что одним из основных факторов может быть воспалительная активность, однако механизмы, лежащие в основе, остаются неясными. В нашей работе произведен анализ изменений артериального русла у пациентов с РА без анамнеза больших сердечно-сосуди- [22][23][24][25][26][27][28]. Нами показано, что маркеры артериальной ригидности в данной популяции встречаются в 2 раза чаще маркеров атеросклероза, при этом наиболее ранним маркером можно считать изменение градиента жесткости, которое встречается более чем у половины пациентов с РА, в том числе и при нормальных значениях кфСРПВ.…”

Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study

“…Two studies studies assessed the relationship between serum lipids and arterial stiffness in RA patients, they found that hyperlipidemia did not significantly correlate with aortic stiffness as measured by carotid femoral pulse wave velocity (cfPWV). 27 , 28 But when the components of the lipids were considered separately, aortic stiffness showed direct associations only with triglycerides. 29 …”

Novel Surrogate Markers of Cardiovascular Risk in the Setting of Autoimmune Rheumatic Diseases: Current Data and Implications for the Future

“…It has been shown that PWV is increased in these patients and that there is an association with age, disease duration, and erythrocyte sedimentation rate (ESR) ( 17 ). Our research group could examine PWV during the last few years in patients with various autoimmune rheumatic diseases, such as rheumatoid arthritis ( 8 ), mixed connective tissue disease (MCTD) ( 7 ), systemic lupus erythematosus (SLE) ( 10 ), and antisynthetase syndrome (ASyS) ( 11 ). In the case of MCTD and ASyS, aortic PWV was statistically significantly higher in comparison to respective control groups even after adjustment for possible confounding factors.…”

“…Furthermore, it is expected that a part of the two-fold higher risk of heart failure and total mortality in RA may be due to myocardial disease associated with inflammation including elevated acute phase proteins, T-Cell subsets, proinflammatory cytokines and the presence of circulating auto-antibodies (5). Autoimmune rheumatic diseases are known to affect the valves, myocardium, pericardium as well as the cardiac vasculature and conduction system, leading to multiple cardiovascular manifestations that in some cases can remain clinically silent or lead to a considerable cardiovascular mortality and morbidity (6)(7)(8)(9)(10). Atherosclerosis plays a substantial role in CVD morbidity and mortality; the degree of coronary atherosclerosis observed in patients with rheumatic diseases can be as accelerated, diffuse, and extensive as in patients with diabetes mellitus (11).…”