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Rheumatoid Arthritis & Collagen Vascular Diseases

Predictors of progression in atherosclerosis over 2 years in systemic lupus erythematosus.
By: Kiani AN, Post WS, Magder LS, Petri M.
Cardiovascular disease remains the major cause of death in systemic lupus erythematosus (SLE). We assessed the degree to which cardiovascular risk factors and disease activity were associated with 2-year changes in measures of subclinical atherosclerosis. Our data did not provide evidence of an association between measures of SLE disease activity (SLEDAI, anti-dsDNA, anti-phospholipid and treatment) and progression of subclinical atherosclerosis. Age and hypertension were associated with the progression of carotid IMT and plaque. Age, smoking and cholesterol were associated with progression of CAC.
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Lupus Atherosclerosis Prevention Study (LAPS).
By: Petri MA, Kiani AN, Post W, Christopher-Stine L, Magder LS.
CVD is one of the major causes of death in SLE. A study (200 patients with SLE without clinical CVD randomized to receive atorvastatin 40 mg daily or an identical placebo) was undertaken to investigate whether treatment with statins would reduce subclinical measures of atherosclerosis over a 2-year period. However, this study provided no evidence that atorvastatin reduces subclinical measures of atherosclerosis or disease activity over 2 years in patients with SLE. In fact, it does not reduce biochemical measures of inflammation. The anti-inflammatory effects of statins observed in the general population were not replicated in this SLE clinical trial.
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Abdominal obesity in rheumatoid arthritis: association with cardiometabolic risk factors and disease characteristics.
By: Giles JT, Allison M, Blumenthal RS, Post W, Gelber AC, Petri M, Tracy R, Szklo M, Bathon JM.
Abdominal adiposity, especially visceral adiposity, is emerging as a recognized cardiometabolic risk factor. This study was undertaken to investigate how abdominal fat is distributed in rheumatoid arthritis (RA), and its RA-related determinants. We compared men and women with RA with non-RA controls from MESA. The distribution of abdominal fat differs significantly by RA status. Higher VFA in men with RA, and the more potent association of VFA with cardiometabolic risk factors in men and women with RA, may contribute to cardiovascular risk in RA populations.
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Abdominal adiposity in rheumatoid arthritis: Association with cardiometabolic risk factors and disease characteristics.
By: Giles JT, Allison M, Blumenthal RS, Post W, Gelber AC, Petri M, Tracy R, Szklo M, Bathon JM.
The distribution of abdominal fat differs significantly by rheumatoid arthritis (RA) status. Higher visceral fat area (VFA) in men with RA, and the more potent association of VFA with cardiometabolic risk factors in men and women with RA, may contribute to cardiovascular risk in RA populations.
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Left ventricular structure and function in patients with rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging.
By: Giles JT, Malayeri AA, Fernandes V, Post W, Blumenthal RS, Bluemke D, Vogel-Claussen J, Szklo M, Petri M, Gelber AC, Brumback L, Lima J, Bathon JM.
Heart failure is a major contributor to cardiovascular morbidity and mortality in patients with RA, but little is known about myocardial structure and function in this population. This study suggests that the progression to heart failure in RA may occur through reduced myocardial mass rather than hypertrophy. Both modifiable and nonmodifiable factors may contribute to lower levels of left ventricular mass and volume.
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Increased prevalence of carotid artery atherosclerosis in rheumatoid arthritis is artery-specific.
By: Kobayashi H, Giles JT, Polak JF, Blumenthal RS, Leffell MS, Szklo M, Petri M, Gelber AC, Post W, Bathon JM.
Compared to controls, RA was associated with a higher prevalence and higher severity of atherosclerosis in the bulb-ICA but not the CCA. Our data suggest that future studies in RA that utilize carotid artery measurements should include assessment of the bulb-ICA.
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