Endothelial Function in Rheumatoid Arthritis.

Endothelial Function in Rheumatoid Arthritis.

QJM. 2018 Jan 15;:

Authors: Adawi M, Watad A, Bragazzi NL, Amital H, Golan S, Rizak S, Arnon B

Abstract
Background: Rheumatoid arthritis (RA) patients are at higher risk of accelerated atherosclerosis. We sought to assess endothelial dysfunction in RA to find a possible mechanistic pathway that will explain this clinical phenomenon.
Methods: A prospective study recruited 44 RA patients with an active long standing (>12 months) disease. All underwent a detailed assessment of disease activity. To estimate the endothelial function the Brachial Artery Method was performed, measuring flow mediated diameter percent change (FMD%). Clustering analyses (hierarchical and k-means) were performed. Patients were compared to healthy subjects.
Results: 44 RA patients (54.42±11.14 years, females (72.7%)) with co-morbidities (70.5%), not taking TNF-blockers or DMARDs (63.6%). Only 6 (13.6%) had a normal endothelial function. Hierarchical and k-means clustering techniques showed statistically significant differences among the three clusters concerning DAS-28-ESR (p = 0.000), DAS-28-CRP (p = 0.001), CDAI (p = 0.002), SDAI (p = 0.001), ESR (p = 0.000), CRP (p = 0.003) and FMD% (p=.009). The group with the highest FMD% values exhibited the lowest clinical scores and laboratory parameters. Patients with the lowest FMD% values co-clustered with subjects with positive but low FMD% changes and elevated clinical and laboratory parameters.
Conclusions: Our study confirmed the feasibility of exploiting endothelial function in clinical practice as an early predictor of atherosclerosis in RA patients.

PMID: 29346649 [PubMed - as supplied by publisher]

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