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Raadsen R, Agca R, Boers M, van Halm VP, Peters MJL, Smulders Y, Beulens JWJ, Blom MT, Stehouwer CDA, Voskuyl AE, Lems WF, Nurmohamed MT. In RA patients without prevalent CVD, incident CVD is mainly associated with traditional risk factors: A 20-year follow-up in the CARRÉ cohort study. Semin Arthritis Rheum 2023; 58:152132. [PMID: 36434892 DOI: 10.1016/j.semarthrit.2022.152132] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To extend our investigation of cardiovascular diseases (CVD) in rheumatoid arthritis (RA) patients to a follow up of more than 20 years, with a special focus on patients without prevalent CVD. METHODS The CARRÉ study is an ongoing prospective cohort study on CV endpoints in RA patients. Results were compared to those of a reference cohort (n = 2484) enriched for type 2 diabetes mellitus (DM). Hazard ratios (HR) for RA and DM patients compared to non-RA/-DM controls were calculated with cox proportional hazard models, and adjusted for baseline SCORE1 (estimated 10-year CVD mortality risk based on CV risk factors). RESULTS 238 RA patients, 117 DM patients and 1282 controls, without prevalent CVD at baseline were included. Analysis of events in these patients shows that after adjustment, no relevant 'RA-specific' risk remains (HR 1.16; 95%CI 0.88 - 1.53), whereas a 'DM-specific' risk is retained (1.73; 1.24 - 2.42). In contrast, adjusted analyses of all cases confirm the presence of an 'RA-specific' risk (1.50; 1.19 - 1.89). CONCLUSIONS In RA patients without prevalent CVD the increased CVD risk is mainly attributable to increased presence of traditional risk factors. After adjustment for these factors, an increased risk attributable to RA only was thus preferentially seen in the patients with prevalent CVD at baseline. As RA treatment has improved, this data suggests that the 'RA-specific' effect of inflammation is preferentially seen in patients with prevalent CVD. We suggest that with modern (early) treatment of RA, most of the current increased CVD risk is mediated through traditional risk factors.
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Affiliation(s)
- R Raadsen
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands.
| | - R Agca
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Department of Rheumatology, Amsterdam, Noord-Holland, the Netherlands
| | - M Boers
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Department of Rheumatology, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Epidemiology & Data Science, Amsterdam, the Netherlands
| | - V P van Halm
- Amsterdam UMC Locatie VUmc, Department of Cardiology, Amsterdam, Noord-Holland, the Netherlands
| | - M J L Peters
- University Medical Centre Utrecht, Department of Internal Medicine, Utrecht, Utrecht, the Netherlands
| | - Y Smulders
- Amsterdam UMC Locatie VUmc, Department of Internal Medicine, Amsterdam, Noord-Holland, the Netherlands
| | - J W J Beulens
- Amsterdam UMC Locatie VUmc, Epidemiology & Data Science, Amsterdam, the Netherlands
| | - M T Blom
- Amsterdam UMC Locatie VUmc, Epidemiology & Data Science, Amsterdam, the Netherlands
| | - C D A Stehouwer
- Maastricht University Medical Centre+, CARIM School for Cardiovascular Diseases, Maastricht, Limburg, the Netherlands; Maastricht University Medical Centre+, Department of Internal Medicine, Maastricht, Limburg, the Netherlands
| | - A E Voskuyl
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Department of Rheumatology, Amsterdam, Noord-Holland, the Netherlands
| | - W F Lems
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Department of Rheumatology, Amsterdam, Noord-Holland, the Netherlands
| | - M T Nurmohamed
- Amsterdam Rheumatology and Immunology Center, Location VUmc and Reade, Amsterdam, Noord-Holland, the Netherlands; Amsterdam UMC Locatie VUmc, Department of Rheumatology, Amsterdam, Noord-Holland, the Netherlands
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Heslinga M, Teunissen C, Agca R, van der Woude D, Huizinga T, van Laar J, den Broeder A, Lems W, Nurmohamed M. NT-proBNP and sRAGE levels in early rheumatoid arthritis. Scand J Rheumatol 2022; 52:243-249. [PMID: 35274588 DOI: 10.1080/03009742.2022.2042975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Several biomarkers of cardiovascular function are found to be increased in rheumatoid arthritis (RA), with some suggesting a relationship with disease activity and improvement with adequate anti-rheumatic treatment. Promising biomarkers include N-terminal pro-brain natriuretic peptide (NT-proBNP) and the soluble receptor form of advanced glycation end-products (sRAGE). The objective of this study was to investigate associations between NT-proBNP and sRAGE levels and markers of inflammation and disease activity in early RA patients and their changes during (effective) anti-rheumatic treatment. METHOD Data from 342 consecutive early RA patients participating in the 'Parelsnoer' cohort were used. At baseline and after 6 months' disease activity, NT-proBNP and sRAGE levels were assessed. RESULTS After 6 months, NT-proBNP decreased from 83 pmol/L (mean) at baseline to 69 pmol/L at follow-up (p < 0.001), while sRAGE increased from 997 pg/mL to 1125 pg/mL (p < 0.001). A larger decrease in erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) was associated with larger changes in NT-proBNP and sRAGE. For every point decrease in ESR, there was a 1.7-point decrease in NT-proBNP and a 2.2-point increase in sRAGE. For CRP, these values were 1.7 and 2.7, respectively (p < 0.001). CONCLUSION Suppressing inflammation, independently of achieving remission, increases sRAGE levels and decreases NT-proBNP levels significantly. Whether this translates into a decrease in incident cardiovascular disease remains to be elucidated.
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Affiliation(s)
- M Heslinga
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center
- Reade, Amsterdam, The Netherlands
| | - C Teunissen
- Department of Clinical Chemistry, Amsterdam UMC, Amsterdam, The Netherlands
| | - R Agca
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center
- Reade, Amsterdam, The Netherlands
| | - D van der Woude
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Twj Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - J van Laar
- Department of Rheumatology, UMC Utrecht, Utrecht, The Netherlands
| | - A den Broeder
- Department of Rheumatology, Radboudumc, Nijmegen, The Netherlands
| | - W Lems
- Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - M Nurmohamed
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center
- Reade, Amsterdam, The Netherlands.,Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
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Raadsen R, Agca R, Voskuyl A, Boers M, Lems W, Nurmohamed M. POS0213 20 Year Follow-Up Of Cardiovascular Event Risk In Rheumatoid Arthritis Compared To Diabetes. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with rheumatoid arthritis have an increased risk for developing cardiovascular diseases (CVD) compared to the general population, similar to the CVD risk in patients with diabetes mellitus. However, there are no controlled studies investigating the incidence of cardiovascular (CV) events in RA patients with follow up of more than 20 years.Objectives:The objectives of the current study were to investigate the incidence rates of CV events in a long-term follow up cohort of RA patients, and to compare these to a similar cohort representing the general population, ie. The Hoorn study.Methods:The CARRÉ study is an ongoing prospective cohort study, which started in 2001, investigating CV mortality and morbidity in 353 randomly selected patients with RA. Primary endpoints, i.e. verified medical history of coronary, cerebral or peripheral arterial disease, were determined at baseline, and after three, ten, fifteen and twenty years of follow up. Patients were censored at the date of an experienced CV event or their death. Incidence density rates per 100 patient years were calculated. Data were compared to results from the Hoorn study, a Dutch cohort study of glucose metabolism and other CV risk factors that began in 1989. All 2,484 participants were subject to an extensive and repeated CV screening program similar to that used in the CARRÉ study.Results:After 20 years of follow up 118 patients (33%) developed at least one CV event in the Carré group. Mean (SD) follow up time was 11 (6) years with a total of 3,500 years at risk and an incidence rate of 3.4 per 100 patient-years; this is slightly up from the figure reported at 15 years, i.e. 3.2 per 100 patient-years. A CV event-free survival curve is shown in figure 1. After 30 years of follow up, 295 participants of the Hoorn study had developed a CV event, during a mean follow up time 20 (8) years. Total time at risk was 50,000 years, with an incidence rate of 0.6 CV events per 100 patient years.Conclusion:In our cohort the incidence rate of CV events in RA patients has remained consistently high when compared with the general population, despite better control of RA inflammation in recent years. This again confirms the need for timely CVD-risk screening and management.References:[1]Agca R, Hopman L, Laan KJC, van Halm VP, Peters MJL, Smulders YM, et al. Cardiovascular Event Risk in Rheumatoid Arthritis Compared with Type 2 Diabetes: A 15-year Longitudinal Study. J Rheumatol. 2020;47(3):316-24.Figure 1.Survival curve of participants with rheumatoid arthritis. RA = rheumatoid arthritisDisclosure of Interests:None declared
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Agca R, Heslinga M, Raterman HG, Simsek S, Voskuyl AE, Nurmohamed MT. Coexistent subclinical hypothyroidism is associated with an increased risk of new cardiovascular events in rheumatoid arthritis: an explorative study. Scand J Rheumatol 2021; 50:441-444. [PMID: 33754936 DOI: 10.1080/03009742.2021.1891279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Autoimmune thyroid disease often coexists with rheumatoid arthritis (RA) and is associated with elevated cardiovascular (CV) risk. However, studies in RA patients are scarce. Our aim was to investigate whether autoimmune thyroid disease increases the risk of new cardiovascular disease (CVD) in RA.Method: Thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) were assessed in 323 RA patients participating in an ongoing prospective cohort study designed to assess CV risk factors, morbidity, and mortality. Cox proportional hazard models were used to calculate hazard ratios (HRs) for new CVD and adjusted for age, gender, smoking, prevalent CVD, thyroxine replacement therapy, and RA duration.Results: Of the 323 participants, 65.3% were female, and mean ± sd age was 63 ± 7 years. At baseline, 8.1% were hypothyroid (n = 26, 16 clinical, 10 subclinical), 6.8% hyperthyroid (n = 22, 13 clinical, 9 subclinical), and 85.1% (n = 275) euthyroid. A new CV event developed in 94 patients (29.1%) during follow-up. Compared to euthyroid patients, the HR adjusted for age, gender, and prevalent CVD was 2.83 [95% confidence interval (CI) 1.13-7.09; p = 0.026] for subclinical hypothyroidism. Further adjustment for smoking, thyroxine replacement therapy, and RA duration resulted in an HR of 3.0 (95% CI 1.19-7.54; p = 0.02) for CV events in patients with subclinical hypothyroidism.Conclusion: There was no difference in CVD between RA patients with hypothyroidism and hyperthyroidism versus euthyroid patients. Coexistence of subclinical hypothyroidism with RA is associated with a higher occurrence of new CV events. Treatment trials are needed to determine whether thyroxine supplementation can further improve CV outcome in these patients.
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Affiliation(s)
- R Agca
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.,Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - M Heslinga
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.,Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - H G Raterman
- Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands.,Department of Rheumatology, Northwest Clinics, Alkmaar, The Netherlands
| | - S Simsek
- Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands
| | - A E Voskuyl
- Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - M T Nurmohamed
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.,Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
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Blanken A, Agca R, Popa CD, Nurmohamed M. AB0238 SERUM LEVELS OF E-SELECTIN AND IL-8 DECREASE AFTER 6 MONTHS OF ANTI-INFLAMMATORY THERAPY AND MIRROR FAVORABLE VASCULAR CHANGES IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Accelerated atherosclerosis is a systemic manifestation of rheumatoid arthritis (RA). E-selectin, VCAM-1, MCP1/CCL2 and IL-8/CXCL8 are involved in leukocyte migration through endothelial cells in both atherosclerosis and RA [1]. Therefore, these endothelial function markers might reflect endothelial function and systemic inflammation in RA. If so, such a marker could be used to assess cardiovascular risk in RA patients.Objectives:The aim of this study was to investigate the effect of 6 months of anti-inflammatory treatment on RA serum levels of endothelial function markers and whether these serum levels are related to prognostic imaging markers for atherosclerosis.Methods:E-selectin, VCAM-1, MCP1 and IL-8 serum levels were determined at baseline and after 6 months of therapy with MTX monotherapy or in combination with adalimumab for 40 RA patients and 19 osteoarthritis (OA) controls using commercial ELISA kits. Prognostic imaging markers for atherosclerosis were pulse wave velocity (PWV) and augmentation index (AIx) as measured with SphygmoCor tonometry. Parametric analyses were used for E-selectin, VCAM-1 and MCP1 and non-parametric or parametric analyses after log transformation for IL-8.Results:Baseline VCAM-1 and IL-8 were significantly higher for RA patients than OA controls with and without adjustment for age and sex or traditional risk factors (table 1).Table 1.Comparison between RA and OA serum levels of endothelial function markers at baselineOARACrude analysisAdjusted age sexAdjusted traditional risk factors*Mean ±SD or median (IQR)Mean ±SD or median (IQR)Difference OA and RA (95%CI)pDifference OA and RA (95%CI)pDifference OA and RA (95%CI)PE-selectin (ng/ml)29 ±1532 ±173 (-6-12)0.493 (-6-12)0.533 (-7-13)0.54VCAM-1 (ng/ml)786 ±102897 ±200110 (13-208)0.03103 (4-202)0.04110 (2-218)0.05MCP1 (pg/ml)248 ±248316 ±16568 (-15-150)0.1171 (-10-152)0.0949 (-41-138)0.28IL-8 (pg/ml)15 (10-25)37 (17-117)n/a0.01n/a0.01n/a0.02* Age, hypertension, bmi and pack yearsAfter 6 months of anti-inflammatory therapy, E-selectin and IL-8 serum levels significantly decreased (table 2). This decrease was especially present in the RA patients with good EULAR-DAS28 response to the medication and not in patients with no/moderate response (E-selectin: -7, 95%CI -13- -2, p=0.007 versus -0.1, 95%CI -3-2, p=0.925; IL-8: -2, p=0.033 versus -1, p=0.267).Table 2.Endothelial function markers difference after 6 months of therapy in RA patientsDifference (95%CI)p-valueE-selectin (ng/ml)-4 (-7-1)0.010VCAM-1 (ng/ml)+10 (-56-77)0.753MCP1 (pg/ml)-14 (-34-62)0.557IL-8 (pg/ml)-11 (n/a)0.014Furthermore, in the RA patients we found a significant correlation between the difference in PWV after 6 months and the difference in E-selectin (Pearson r=0.450, p=0.018) and IL-8 (Spearman r=0.401, p=0.038). All other possible correlations of the endothelial function markers with PWV and AIx were not significant (data not shown).Conclusion:Serum levels of E-selectin and IL-8 decreased after 6 months of anti-inflammatory therapy, and both correlated with the PWV changes. This is the first study investigating both serologic as well as imaging markers of endothelial function and atherosclerosis in RA patients undergoing anti-inflammatory therapy. Our study suggests that E-selectin and IL-8 circulatory levels may reflect the best both systemic inflammation as well as endothelial function in RA, and might be therefore useful in the future as markers of cardiovascular risk in these patients.References:[1]Haringman et al. Targeting cellular adhesion molecules, chemokines and chemokine receptors in rheumatoid arthritis. Expert Opin Emerg Drugs, 2005. 10(2): p. 299-310.Disclosure of Interests:Annelies Blanken: None declared, Rabia Agca: None declared, C.D. Popa: None declared, Michael Nurmohamed Grant/research support from: Not related to this research, Consultant of: Not related to this research, Speakers bureau: Not related to this research
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Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJL, Kvien TK, Dougados M, Radner H, Atzeni F, Primdahl J, Södergren A, Wallberg Jonsson S, van Rompay J, Zabalan C, Pedersen TR, Jacobsson L, de Vlam K, Gonzalez-Gay MA, Semb AG, Kitas GD, Smulders YM, Szekanecz Z, Sattar N, Symmons DPM, Nurmohamed MT. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 2016; 76:17-28. [DOI: 10.1136/annrheumdis-2016-209775] [Citation(s) in RCA: 683] [Impact Index Per Article: 85.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/24/2016] [Accepted: 09/08/2016] [Indexed: 12/28/2022]
Abstract
Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.
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Maracle C, Agca R, Helder B, Niessen H, Nurmohamed M, Tas S. AB0265 Non-Canonical NF-κB Signaling in Microvessels of Atherosclerotic Lesions in Coronary Arteries Is Associated with Inflammatory Cell Infiltration and Myocardial Infarction. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agca R, Heslinga SC, van Halm VP, Nurmohamed MT. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders. Heart 2016; 102:790-5. [PMID: 26888573 DOI: 10.1136/heartjnl-2015-307838] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/11/2016] [Indexed: 01/20/2023] Open
Abstract
Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care.
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Affiliation(s)
- R Agca
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - S C Heslinga
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - V P van Halm
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - M T Nurmohamed
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
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Maracle CX, Agca R, Helder B, Niessen HWM, Nurmohamed M, Tas SW. A10.11 Non-canonical nf-κb signalling in microvessels of atherosclerotic lesions in coronary arteries is associated with inflammatory cell infiltration and myocardial infarction. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agca R, Raterman H, Simsek S, Voskuyl A, Nurmohamed M. FRI0095 Subclinical Hypothyroidism is Associated with an Increased Risk of Cardiovascular Events in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Visman I, Agca R, Voskuijl A, Lems W, Nurmohamed M. AB0455 Good Response on Rituximab Treatment for Patients with Rheumatoid Arthritis Persists for Up to 4 Years. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Visman I, Agca R, Voskuijl A, Nurmohamed M. AB0457 Patient Reported Adverse Events on Rituximab Treatment for Rheumatoid Arthritis: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Agca R, van Sijl A, Smulders Y, Voskuyl A, van der Laken C, Boellaard R, Lensen KJ, Nurmohamed M. SAT0100 Increased Vascular Wall Inflammation in Patients with Early Rheumatoid Arthritis as Measured by 18F-FDG-PET/CT. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agca R, van Sijl A, Voskuyl A, Nurmohamed M. SAT0131 Uric Acid is Associated with Metabolic Syndrome in Longstanding Rheumatoid Arthritis: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Agca R, van Sijl A, Voskuyl A, Nurmohamed M. SAT0097 Predicting Cardiovascular Risk in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Van Dongen C, Agca R, Trivino L, Vogelzang E, Nurmohamed M. SAT0388 Effect of Etanercept Therapy on Lipid Profile in Patients with Psoriatic Arthritis:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agca R, Sijl A, Smulders Y, Voskuyl A, van der Laken C, Boellaard R, Lensen K, Nurmohamed M. AB1007 Increased Vascular Wall Inflammation in Patients with Active Rheumatoid Arthritis as Measured by an 18F-Fdg-Pet/Ct Scan. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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