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Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis.
Arthritis Rheum 2005; 52(11):3413-23AR

Abstract

OBJECTIVE

To estimate the contribution of cardiovascular (CV) risk factors and rheumatoid arthritis (RA) disease manifestations to atherosclerosis in RA.

METHODS

We used high-resolution carotid ultrasound to measure the carotid intima-media thickness (IMT) and plaque in 631 RA patients. Using R(2) measures from multivariable models, we estimated the contribution of demographic characteristics (age, sex, and ethnic group), CV risk factors (diabetes mellitus, hypercholesterolemia, cigarette smoking, hypertension, and body mass index, and RA manifestations (joint tenderness, swelling, and deformity, nodules, erythrocyte sedimentation rate [ESR], C-reactive protein, rheumatoid factor, the HLA-DRB1 shared epitope, and cumulative glucocorticoid dose) to each of the outcomes. Estimates were obtained in the full sample, and within strata defined by age, sex, and ethnic group. We tested for interaction between CV risk factors and RA manifestations.

RESULTS

The contribution of demographic factors, CV risk factors, and RA manifestations to IMT and plaque R(2) varied depending on the patients' age stratum. Demographic features explained 11-16% of IMT variance, CV risk factors explained 4%-12%, and RA manifestations explained 1-6%. The greatest contribution of RA manifestations occurred in the youngest age group, while that of CV risk factors occurred in the older age groups. Results for carotid plaque were similar. There was a significant interaction between the number of CV risk factors present and the ESR, suggesting that the ESR's effect on IMT varied according to the number of CV risk factors.

CONCLUSION

Both established CV risk factors and manifestations of RA inflammation contribute significantly to carotid atherosclerosis in RA, and may modify one another's effects. These findings may have implications regarding the prevention of atherosclerosis in RA.

Authors+Show Affiliations

University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA. delrincon@uthscsa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16255018

Citation

del Rincón, Inmaculada, et al. "Relative Contribution of Cardiovascular Risk Factors and Rheumatoid Arthritis Clinical Manifestations to Atherosclerosis." Arthritis and Rheumatism, vol. 52, no. 11, 2005, pp. 3413-23.
del Rincón I, Freeman GL, Haas RW, et al. Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis. Arthritis Rheum. 2005;52(11):3413-23.
del Rincón, I., Freeman, G. L., Haas, R. W., O'Leary, D. H., & Escalante, A. (2005). Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis. Arthritis and Rheumatism, 52(11), pp. 3413-23.
del Rincón I, et al. Relative Contribution of Cardiovascular Risk Factors and Rheumatoid Arthritis Clinical Manifestations to Atherosclerosis. Arthritis Rheum. 2005;52(11):3413-23. PubMed PMID: 16255018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis. AU - del Rincón,Inmaculada, AU - Freeman,Gregory L, AU - Haas,Roy W, AU - O'Leary,Daniel H, AU - Escalante,Agustín, PY - 2005/10/29/pubmed PY - 2005/12/13/medline PY - 2005/10/29/entrez SP - 3413 EP - 23 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 52 IS - 11 N2 - OBJECTIVE: To estimate the contribution of cardiovascular (CV) risk factors and rheumatoid arthritis (RA) disease manifestations to atherosclerosis in RA. METHODS: We used high-resolution carotid ultrasound to measure the carotid intima-media thickness (IMT) and plaque in 631 RA patients. Using R(2) measures from multivariable models, we estimated the contribution of demographic characteristics (age, sex, and ethnic group), CV risk factors (diabetes mellitus, hypercholesterolemia, cigarette smoking, hypertension, and body mass index, and RA manifestations (joint tenderness, swelling, and deformity, nodules, erythrocyte sedimentation rate [ESR], C-reactive protein, rheumatoid factor, the HLA-DRB1 shared epitope, and cumulative glucocorticoid dose) to each of the outcomes. Estimates were obtained in the full sample, and within strata defined by age, sex, and ethnic group. We tested for interaction between CV risk factors and RA manifestations. RESULTS: The contribution of demographic factors, CV risk factors, and RA manifestations to IMT and plaque R(2) varied depending on the patients' age stratum. Demographic features explained 11-16% of IMT variance, CV risk factors explained 4%-12%, and RA manifestations explained 1-6%. The greatest contribution of RA manifestations occurred in the youngest age group, while that of CV risk factors occurred in the older age groups. Results for carotid plaque were similar. There was a significant interaction between the number of CV risk factors present and the ESR, suggesting that the ESR's effect on IMT varied according to the number of CV risk factors. CONCLUSION: Both established CV risk factors and manifestations of RA inflammation contribute significantly to carotid atherosclerosis in RA, and may modify one another's effects. These findings may have implications regarding the prevention of atherosclerosis in RA. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/16255018/Relative_contribution_of_cardiovascular_risk_factors_and_rheumatoid_arthritis_clinical_manifestations_to_atherosclerosis_ L2 - https://doi.org/10.1002/art.21397 DB - PRIME DP - Unbound Medicine ER -