Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome.
Atherosclerosis
; 271: 84-91, 2018 04.
Article
en En
| MEDLINE
| ID: mdl-29482038
ABSTRACT
BACKGROUND AND AIMS:
Rheumatoid arthritis (RA) has been associated with an increased risk of atherosclerosis. We aimed to evaluate the progression of carotid intima media thickness (cIMT) in RA patients subject to a cardiovascular treat-to-target intervention. In addition, the presence of the metabolic syndrome (MetS) on cIMT outcomes was evaluated.METHODS:
We performed a cohort analysis of FRANCIS, in which RA patients ≤70 years without CVD or diabetes mellitus were randomized for either a treat-to-target intervention or usual care concerning CVD risk factors. MetS was scored at baseline.RESULTS:
Three-year data was available in 212 well-controlled RA patients. The treat-to-target intervention resulted in a lower cIMT progression over three years compared to the usual care. However, there was no difference in cIMT at three years between groups. MetS was present in 40.1% of RA patients. Baseline cIMT was significantly higher in RA patients with MetS compared to those without (0.619 (0.112) versus 0.557 (0.104) mm; pâ¯<â¯0.001). After three years, cIMT progression was comparable (0.043 (0.071) versus 0.043 (0.072) mm; pâ¯=â¯0.96). In RA patients with MetS, the presence of plaques increased over three years from 12.9% to 23.5% (pâ¯=â¯0.01). The type of intervention had no effect on cIMT progression in RA patients with MetS. However, in subjects without MetS, treat-to-target resulted in a lower progression.CONCLUSIONS:
RA patients with MetS showed an increased CVD risk profile based on both a higher prevalence of CVD risk factors and structural vascular changes. A treat-to-target approach of CVD risk factors reduced cIMT progression only in RA patients without MetS.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Artritis Reumatoide
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Enfermedades de las Arterias Carótidas
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Arteria Carótida Común
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Síndrome Metabólico
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
País/Región como asunto:
Europa
Idioma:
En
Revista:
Atherosclerosis
Año:
2018
Tipo del documento:
Article