1. Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome.
- Author
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Burggraaf B, van Breukelen-van der Stoep DF, de Vries MA, Klop B, van Zeben J, van de Geijn GM, van der Meulen N, Birnie E, Prinzen L, and Castro Cabezas M
- Subjects
- Adult, Aged, Antihypertensive Agents therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid diagnosis, Arthritis, Rheumatoid mortality, Arthritis, Rheumatoid therapy, Asymptomatic Diseases, Carotid Artery Diseases diagnostic imaging, Carotid Artery Diseases mortality, Carotid Artery Diseases prevention & control, Carotid Intima-Media Thickness, Disease Progression, Female, Humans, Hypoglycemic Agents therapeutic use, Hypolipidemic Agents therapeutic use, Male, Metabolic Syndrome diagnosis, Metabolic Syndrome mortality, Metabolic Syndrome therapy, Middle Aged, Netherlands epidemiology, Plaque, Atherosclerotic, Prevalence, Prospective Studies, Risk Assessment, Risk Factors, Risk Reduction Behavior, Time Factors, Treatment Outcome, Arthritis, Rheumatoid epidemiology, Carotid Artery Diseases epidemiology, Carotid Artery, Common diagnostic imaging, Metabolic Syndrome epidemiology
- 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; p < 0.001). After three years, cIMT progression was comparable (0.043 (0.071) versus 0.043 (0.072) mm; p = 0.96). In RA patients with MetS, the presence of plaques increased over three years from 12.9% to 23.5% (p = 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., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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