Mendoza CU, Alonso BME

Language: Spanish
References: 16
Page: 105-116
PDF size: 281.23 Kb.

ABSTRACT

Introduction: the prognosis of coronary risk from the activity in rheumatoid arthritis is still a problem.
Objectives: to evaluate the predictive capacity of rheumatoid factor, C-reactive protein, C3-C4 complement, and the activity index of the disease using 28 joints on coronary risk in this disease.
Methods: a longitudinal-prospective study was carried out in a sample of 50 patients. The serum levels of: rheumatoid factor, c-reactive protein, C3, C4 complement, lipoprotein (a), apolipoproteins B and A1 were determined by immunoturbidimetric method, while total cholesterol, low-density lipoprotein cholesterol and high-density cholesterol by enzyme-correlated assay. The erythrocyte sedimentation rate was determined by the Westergreen method. Coronary risk was defined according to desirable values, or not, of the indicators: lipoprotein (a), Apolipoprotein B/Apolipoprotein A1 ratios, low density lipoprotein cholesterol / high density lipoprotein cholesterol, Apolipoprotein B/low lipoprotein cholesterol density and atherogenic index. The statistical program SPSS, version 18.0 was used for the analysis.
Results: the profile of immunoinflammatory activity of the uptake showed adequate predictive capacity on coronary risk [logistic regression: Hosmer and Lemeshow test: (p= 0.54), overall percentage of correct prediction: 64 and 90 %, to the first and third month]. The variables C3 complement, C4 complement and index of disease activity contributed to the direct prediction of coronary risk according to the Apolipoprotein B / Apolipoprotein A1, low density lipoprotein cholesterol / high density lipoprotein cholesterol and atherogenic index (p associated with Odds ratio ≤ 0.05). The lipoprotein metabolism markers studied, except for the Apolipoprotein B / low density lipoprotein cholesterol ratio, corresponding to the month and third month of follow-up were predicted from C4, C3 complement, disease activity index and C-reactive protein at the time of the uptake (linear regression: R2 with associated p≤ 0.05). The rheumatoid factor did not contribute to the longitudinal prediction of coronary risk studied.
Conclusions: the usefulness of the profile of activity markers of rheumatoid arthritis analyzed in the prediction of coronary risk was demonstrated.

REFERENCES

1. Abdel M, Laban A, Hasan A, Farouk A. The clinical value of anti-cyclic citrullinated peptide (anti-ccp) antibodies and insulin resistance (IR) in detection of early and subclinical atherosclerosis in rheumatoid arthritis (RA). The Egyptian Heart Journal. 2015;68:109-16.

2. Santos A, Rodríguez M, Meaney A, Gutiérrez G, Velázquez H, Rubio I, et al. Atherosclerotic risk in middle-aged women with rheumatoid arthritis. Revista Mexicana de Cardiología. 2015;26(2):70-7.

3. Kaplan MJ. Cardiovascular Complications of Rheumatoid Arthritis: Assessment, Prevention, and Treatment. Rheumatics Diseases Clinics of North America. 2010;36(2):405-26.

4. Sharif O, Battacharya R, Battacharyya K, Nath R, Das A, ChaKraborty D, et al. Lipid profile and its relationship with endothelial dysfunction and disease activity in patients of early Rheumatoid Arthritis. Indian Journal of Rheumatology. 2014;9:9-13.

5. Mendoza U, Alonso ME. Factor reumatoide. Asociación con marcadores de riesgo aterogénico en pacientes con artritis reumatoide. Rev Cubana de Reumatología. 2015;17(2):151-7.

6. Van Breukelen DF, Klop B, Van Zeben D, Hazes JM, Castro M. Cardiovascular Risk in rheumatoid arthritis: How to lower the risk? Atherosclerosis. 2013;231(1):163-72.

7. Peters M, Nurmohamed MT. Cardiovascular risk management in rheumatoid arthritis: are we still waiting for the first step? Arthritis Research & Therapy. 2013;15:111.

8. Wallach J. Enfermedades cardiovasculares. En: Centro Nacional de Información de Ciencias Médicas, editor. Interpretación clínica de las pruebas de laboratorio. La Habana: Ed. Ciencias Médicas; 2006. p. 142.

9. Liao K, Maini RN. Coronary artery disease in rheumatoid arthritis: Pathogenesis, risk factors, clinical manifestations, and diagnostic implications. Arthritis Rheum 2016;74:7481.

10. Chung W, Lin CHL, Ling CH, Chen Y, Chin CH, Chang F, et al. Rheumatoid arthritis and risk of acute myocardial infarction-A nationwide retrospective cohort study. International Journal of Cardiology. 2013;168(5):4750-4.

11. Gabay C, Buchs N, Dudler J, Hasler P, Gencer B, Matter CH, et al. Cardiovascular risk management in patients with rheumatoid arthritis: Consensus guidelines. Cardiovascular Medicine. 2015;18(4):127-33.

12. Houri E, Watad A, Whitby A, Tiosano S, Comaneshter D, Arnon D, et al. Coexistence of ischemic heart disease and rheumatoid arthritis patients-Acase control study. Autoimmunity Reviews. 2016;15(4):393-6.

13. Holc I, Hois R, Cikes N, Ambrozic A, Cucnik S, Kveder T, et al. Antiphospholipid antibodies and atherosclerosis: Insights from Rheumatoid arthritis-A five year follow up study. Immunobiology. 2011;216(12):1331-7.

14. Giles G. Cardiovascular disease in rheumatoid arthritis: Current perspectives on assessing and mitigating risk in clinical practice. Best Practice & Research Clinical Rheumatology. 2015;29:597-613.

15. Arts E, Popa C, Broeder A, Donders R, Sandoo A, Toms T, et al. Predicction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms. Ann Rheum Disease. 2015;10:1136.

16. Szekanecz Z, Kerekes G, Kardos Z, Baráth Z, Tamási L. Mechanisms of Inflammatory Atherosclerosis in Rheumatoid Arthritis. Current Immunology Reviews. 2016;12:35-46.