title: Accelerated atherosclerosis in rheumatoid arthritis.
abstract: Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. Both traditional, Framingham risk factors and inflammation-associated factors are involved in RA-associated atherosclerosis. Among imaging techniques, the early determination of common carotid intima-media thickness (ccIMT), flow-mediated vasodilation (FMD), and nitroglycerine-mediated vasodilation (NMD) may be useful to determine atherosclerosis and endothelial dysfunction. We and others found increased ccIMT and impaired FMD in RA patients. Among immunological and metabolic laboratory markers, anticyclic citrullinated peptide (anti-CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, pro-inflammatory cytokines including tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), Th0/Th1 T cells, homocysteine, dyslipidemia, decreased folate and vitamin B12 production, and impaired paraoxonase activity may all be involved in the development of vascular disease in RA. The early diagnosis of endothelial dysfunction and atherosclerosis, active immunosuppressive treatment, the use of drugs that control atherosclerosis, changes in sedentary lifestyle, and the close follow-up of RA patients may help to minimize cardiovascular risk in these individuals.
authors: Division of Rheumatology, Third Department of Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary. szekanecz@iiibel.dote.hu
authors: Zoltán
authors: Z
authors: Szekanecz
authors: György
authors: G
authors: Kerekes
authors: Henriett
authors: H
authors: Dér
authors: Zsuzsa
authors: Z
authors: Sándor
authors: Zoltán
authors: Z
authors: Szabó
authors: Anikó
authors: A
authors: Végvári
authors: Enikö
authors: E
authors: Simkovics
authors: Lilla
authors: L
authors: Soós
authors: Agnes
authors: A
authors: Szentpétery
authors: Timea
authors: T
authors: Besenyei
authors: Gabriella
authors: G
authors: Szücs
authors: Sándor
authors: S
authors: Szántó
authors: László
authors: L
authors: Tamási
authors: Gyula
authors: G
authors: Szegedi
authors: Yehuda
authors: Y
authors: Shoenfeld
authors: Pál
authors: P
authors: Soltész
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D004730:Endothelium, Vascular / Q000473:pathology*; D006801:Humans; D012307:Risk Factors