Тематичний Архів | Category Archives: Rheumatology

O.O. Garmish, V.G. Levchenko, Yu.M. Sirenko, M.R. Ikorkin. Assessment of inflammatory factors and peripheral vessels involvement as markers of cardiovascular risk among women with rheumatoid arthritis

The aim – to assess inflammatory factors and peripheral vessels involvement as markers of cardiovascular risk among women with rheumatoid arthritis.

Materials and methods. 105 women with proved diagnosis of rheumatoid arthritis according to ACR 1987 and ACR/EULAR 2010 criteria were examined. Laboratory assessments consisted of biochemistry and hematology analysis, measuring of CRP level, rheumatoid factor, anti-CCP level, total cholesterol, HDL, LDL, thyroglobulin, apoliprotein A1, apoliprotein B, uric acid, HbA1c, microalbuminuria. DAS28 was used in characterizing RA activity. Cardiovascular risk was defined per mSCORE with following gradation: low, middle, high and very high level. For purpose of atherosclerosis progression monitoring carotid ultrasound was performed, using B regimen defining surrogate marker of systemic atherosclerosis CIMT in 3 points. Thickness of CIM on the level of atheromatous plaque was not taken into account while measuring average CIMT. Morphology of CIM was evaluated taking into account layered differentiation, echogenicity, induration and fragmentation of intima.

Results. Cardiovascular risk occurrence per mSCORE was elevated among patients elder than 45 years; substantial differences in quantitative indices were revealed in groups of patients aged 46–60 and > 60 years. Among female patients of reproductive age, 83.3 % patients did not experience cardiovascular risk, 11.1 % experienced middle level and 5.6 % experienced low level of cardiovascular risk. CIM thickness and calcinosis were considerably rarely met in women aged < 45 years. All women with cardiovascular risk demonstrated disturbed differentiation to layers and echogenicity, thickened and fragmented vessels intima. Tibial artery thickness serves as a peculiarity related to both traditional and surrogate factors of cardiovascular risk. Conclusions. It might be assumed that personalized approach in defining the possibility of cardiovascular diseases occurrence is vital and new important factors of their development are inflammatory process aggressiveness of RA, presence of anti-CCP, CIM and tibial artery thickness, disorder of linear velocity of blood flow against traditional factors, like increase of LDL and presence of menopause.

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