Accelerated atherosclerosis in premenopausal women with rheumatoid arthritis – 15-year follow-up

  • Metka Koren Krajnc Division of Internal Medicine, Department of Rheumatology, University Medical Centre Maribor, Maribor, Slovenia; Medical Faculty, University of Maribor, Maribor, Slovenia https://orcid.org/0000-0002-9115-3832
  • Radovan Hojs Medical Faculty, University of Maribor, Maribor, Slovenia; Division of Internal Medicine, Department of Nephrology, University Medical Centre Maribor, Maribor, Slovenia
  • Iztok Holc Division of Internal Medicine, Department of Rheumatology, University Medical Centre Maribor, Maribor, Slovenia; Medical Faculty, University of Maribor, Maribor, Slovenia https://orcid.org/0000-0003-0412-5129
  • Željko Knez Medical Faculty, University of Maribor, Maribor, Slovenia; Faculty of Chemistry and Chemical Engeneering, University of Maribor, Maribor, Slovenia
  • Artur Pahor Division of Internal Medicine, Department of Rheumatology, University Medical Centre Maribor, Maribor, Slovenia; Medical Faculty, University of Maribor, Maribor, Slovenia
Keywords: Rheumatoid arthritis, atherosclerosis, cardiovascular disease, metalloproteases

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased mortality and morbidity due to the higher cardiovascular risk in these patients. Traditional risk factors are not the only answer for the accelerated atherosclerosis. In a long-term prospective study, we investigated the relationship between asymptomatic atherosclerosis and traditional risk factors and inflammatory markers in patients with RA and matched healthy controls. We studied the laboratory test results, the concentrations of inflammatory mediators, matrix metalloproteases (MMP), and inflammation markers in a total of 70 (60 at follow-up) premenopausal healthy women with RA and 40 (34 at follow-up) matched controls. We used the B-mode ultrasound imaging of carotid arteries for the detection of asymptomatic atherosclerosis. Correlation with different factors was evaluated. Statistically significant higher values of inflammatory markers such as selective adhesion molecules ICAM and VCAM, interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and MMP-3 in the patients group were found in the follow-up study. More plaques were found in the patients group (42.4% vs. 12.9%; p=0.005), as compared with the controls group. The patients had also higher values of cIMT (p=0.001). Using bivariate regression analysis only VCAM was found as a prognostic factor for plaque occurrence (r= 0. 341, p=0.016), but not for cIMT (r= -0.130, p=0.327) in premenopausal female patients with RA after the follow-up. Therefore, asymptomatic atherosclerosis is accelerated in premenopausal women with RA. The results of our follow-up study showed the association between inflammation and accelerated atherosclerosis. Furthermore, VCAM was found to have a statistically significant correlation with plaque occurrence in these patients. 

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Accelerated atherosclerosis in premenopausal women with rheumatoid arthritis – 15-year follow-up
Published
2020-11-25
How to Cite
1.
Koren KrajncM, HojsR, HolcI, Knez Željko, PahorA. Accelerated atherosclerosis in premenopausal women with rheumatoid arthritis – 15-year follow-up. Bosn J of Basic Med Sci [Internet]. 2020Nov.25 [cited 2021Jan.26];. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/5176
Section
Translational and Clinical Research