CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)

Objective: to estimate the level of cardiovascular risk in patients with early rheumatoid arthritis (RA) before therapy with disease-modifying antirheumatic drugs (DMARDs).Subjects and methods: Seventy-three patients with early RA who had not previously taken DMARDs or glucocorticoids were examined....

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Main Authors: Yu. N. Gorbunova, D. S. Novikova, T. V. Popkova, E. I. Markelova, Yu. O. Korsakova, O. A. Fomicheva, D. S. Kolmakova, E. L. Luchikhina, D. E. Karateev, A. V. Smirnov, E. L. Nasonov
Format: Article
Language:Russian
Published: IMA PRESS LLC 2014-09-01
Series:Научно-практическая ревматология
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Online Access:https://rsp.mediar-press.net/rsp/article/view/1958
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author Yu. N. Gorbunova
D. S. Novikova
T. V. Popkova
E. I. Markelova
Yu. O. Korsakova
O. A. Fomicheva
D. S. Kolmakova
E. L. Luchikhina
D. E. Karateev
A. V. Smirnov
E. L. Nasonov
author_facet Yu. N. Gorbunova
D. S. Novikova
T. V. Popkova
E. I. Markelova
Yu. O. Korsakova
O. A. Fomicheva
D. S. Kolmakova
E. L. Luchikhina
D. E. Karateev
A. V. Smirnov
E. L. Nasonov
author_sort Yu. N. Gorbunova
collection DOAJ
description Objective: to estimate the level of cardiovascular risk in patients with early rheumatoid arthritis (RA) before therapy with disease-modifying antirheumatic drugs (DMARDs).Subjects and methods: Seventy-three patients with early RA who had not previously taken DMARDs or glucocorticoids were examined. Disease activity was assessed by the DAS28, SDAI, and CDAI. All the patients were examined by a cardiologist. The investigators assessed traditional risk factors (RF), by determining the overall coronary risk according tothe modified SCORE scale, the degree of a risk for cardiovascular events (CVE), carried out 24-hour ECG and blood pressure monitoring, echocardiography (EchoCG), and carotid duplex scanning, identified coronary artery calcification by multislice spiral computed tomography, and, if indicated, performed stress EchoCG and coronary angiography.Results. The diagnosis of coronary heart disease was established in 13 patients. NYHA functional class I or II chronic heart failure (HF) was diagnosed in 8 patients, systolic HF in 2, HF with preserved left ventricular ejection fraction in 6 cases. There was left ventricular hypertrophy in 22 (30.1%) patients, carotid atherosclerotic plaques in 26 (35.6%), coronary artery calcification in 30 (41.1%), hypertension in 38 (52.1%), abdominal obesity in 34 (46.6%), dyslipidemia in 40 (54.8%), hypercholesterolemia in 37 (50.7%), hypoalphalipoproteinemia in 21 (28.8%), hypertriglyceridemia in 12 (16.4%), low physical activity in 30 (41.1%), and smoking in 13 (17.8%). Thirty-three of 53 women weremenopausal. Fasting hyperglycemia was found in 11 (15.1%) patients; type 2 diabetes mellitus in 4 (5.5%). Thirty-one (42.5%) patients had at least three RFs. In accordance with the current classification of the degree of cardiovascular risk, very high, high, moderate, and low risks for CVE were observed in 58, 8, 8, and 26% of the RA patients, respectively.Conclusion. Most rheumatoid factor- and anticyclic citrullinated peptide-positive patients with early RA and high disease activity have high and very high cardiovascular risks.
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spelling doaj.art-2287403833b04c8da2837c0cd56858ff2025-03-02T13:23:39ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922014-09-0152438138610.14412/1995-4484-2014-381-3861890CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)Yu. N. Gorbunova0D. S. Novikova1T. V. Popkova2E. I. Markelova3Yu. O. Korsakova4O. A. Fomicheva5D. S. Kolmakova6E. L. Luchikhina7D. E. Karateev8A. V. Smirnov9E. L. Nasonov10V.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowRussian Cardiology Research-and- Production Complex, Ministry of Health of Russia, MoscowRussian Cardiology Research-and- Production Complex, Ministry of Health of Russia, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowV.A. Nasonova Research Institute of Rheumatology, MoscowObjective: to estimate the level of cardiovascular risk in patients with early rheumatoid arthritis (RA) before therapy with disease-modifying antirheumatic drugs (DMARDs).Subjects and methods: Seventy-three patients with early RA who had not previously taken DMARDs or glucocorticoids were examined. Disease activity was assessed by the DAS28, SDAI, and CDAI. All the patients were examined by a cardiologist. The investigators assessed traditional risk factors (RF), by determining the overall coronary risk according tothe modified SCORE scale, the degree of a risk for cardiovascular events (CVE), carried out 24-hour ECG and blood pressure monitoring, echocardiography (EchoCG), and carotid duplex scanning, identified coronary artery calcification by multislice spiral computed tomography, and, if indicated, performed stress EchoCG and coronary angiography.Results. The diagnosis of coronary heart disease was established in 13 patients. NYHA functional class I or II chronic heart failure (HF) was diagnosed in 8 patients, systolic HF in 2, HF with preserved left ventricular ejection fraction in 6 cases. There was left ventricular hypertrophy in 22 (30.1%) patients, carotid atherosclerotic plaques in 26 (35.6%), coronary artery calcification in 30 (41.1%), hypertension in 38 (52.1%), abdominal obesity in 34 (46.6%), dyslipidemia in 40 (54.8%), hypercholesterolemia in 37 (50.7%), hypoalphalipoproteinemia in 21 (28.8%), hypertriglyceridemia in 12 (16.4%), low physical activity in 30 (41.1%), and smoking in 13 (17.8%). Thirty-three of 53 women weremenopausal. Fasting hyperglycemia was found in 11 (15.1%) patients; type 2 diabetes mellitus in 4 (5.5%). Thirty-one (42.5%) patients had at least three RFs. In accordance with the current classification of the degree of cardiovascular risk, very high, high, moderate, and low risks for CVE were observed in 58, 8, 8, and 26% of the RA patients, respectively.Conclusion. Most rheumatoid factor- and anticyclic citrullinated peptide-positive patients with early RA and high disease activity have high and very high cardiovascular risks.https://rsp.mediar-press.net/rsp/article/view/1958rheumatoid arthritiscardiovascular risktraditional risk factorsscore
spellingShingle Yu. N. Gorbunova
D. S. Novikova
T. V. Popkova
E. I. Markelova
Yu. O. Korsakova
O. A. Fomicheva
D. S. Kolmakova
E. L. Luchikhina
D. E. Karateev
A. V. Smirnov
E. L. Nasonov
CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
Научно-практическая ревматология
rheumatoid arthritis
cardiovascular risk
traditional risk factors
score
title CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
title_full CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
title_fullStr CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
title_full_unstemmed CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
title_short CARDIOVASCULAR RISK IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS BEFORE DISEASE-MODIFYING ANTIRHEUMATIC THERAPY (PRELIMINARY DATA OF THE REMARCА STUDY)
title_sort cardiovascular risk in patients with early rheumatoid arthritis before disease modifying antirheumatic therapy preliminary data of the remarcа study
topic rheumatoid arthritis
cardiovascular risk
traditional risk factors
score
url https://rsp.mediar-press.net/rsp/article/view/1958
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