Kardiorespirator tadqiqotlar jurnali. Maxsus son. 2022
Subject of the article
CARDIOVASCULAR DISEASE RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH CONVENTIONAL DMARDS: A СASE CONTROL STUDY (444-449)
Authors
Ibragimov K.I., Sultonov I.I., Ziyadullayev Sh.X.
Institution
Samarkand State Medical University
Abstract
Study objectives. This study examines possible associations between cardiovascular disease and the utilization of conventional DMARDs in patients with RA. Materials and methods. Using a case-control study design, 246 patients with RA (82 with CVD and 164 without CVD) were studied. Data on RA, CVD, and DMARDs therapy were assessed from the verified medical history data. Results and discussion. MTX treatment showed an association with a significant reduction in CVD risk: “MTX only”, OR 0.18 (95% CI 0.09-0.74); "MTX and SSZ ever", OR 0.22 (95% CI 0.12-0.53). After additional correction, the risk reductions with the treatment remained significant for rheumatoid factor presence. While adjusting for diabetes, hypertension and high blood cholesterol level, only “MTX or SSZ” group showed a significant reduction in CVD risk. Rheumatoid factor significantly increased CVD risk, with an OR of 2.47 (95% CI 1.21 to 5.88). Conclusions. This study suggests that the use of DMARD, in particular the use of MTX, results in potent suppression of joint inflammation. It also can reduce the development of atherosclerosis and associated CVDs.
Key words
RA, CVD, risk, DMARD, case-control, methotrexate
Literature
1. Jamnitski, A., Visman, I. M., Peters, M. J. L., Boers, M., Dijkmans, B. A. C., & Nurmohamed, M. T. (2011). Prevalence of cardiovascular diseases in psoriatic arthritis resembles that of rheumatoid arthritis. Annals of the rheumatic diseases, 70(5), 875-876. 2. Panoulas, V. F., Douglas, K. M., Milionis, H. J., et al. (2007). Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis. Rheumatology, 46(9), 1477-1482. 3. Van Halm, V. P., Peters, M. J. L., Voskuyl, A. E., Boers, M., Lems, W. F., Visser, M., ... & Nurmohamed, M. T. (2009). Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation. Annals of the rheumatic diseases, 68(9), 1395-1400. 4. Pappas, D. A., Nyberg, F., Kremer, J. M., Lampl, K., Reed, G. W., Horne, L., ... & Greenberg, J. D. (2018). Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study. Clinical rheumatology, 37(9), 2331-2340. 5. Sarmiento-Monroy, J. C., Amaya-Amaya, J., Espinosa-Serna, J. S., Herrera-Díaz, C., Anaya, J. M., & Rojas-Villarraga, A. (2012). Cardiovascular disease in rheumatoid arthritis: a systematic literature review in Latin America. Arthritis, 2012. 6. Wasko, M. C., Kay, J., Hsia, E. C., & Rahman, M. U. (2011). Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: risk reduction in a chronic inflammatory disease. Arthritis care & research, 63(4), 512-521. 7. Libby, P. (2008). Role of inflammation in atherosclerosis associated with rheumatoid arthritis. The American journal of medicine, 121(10), S21-S31. 8. Westlake, S. L., Colebatch, A. N., Baird, J., Kiely, P., Quinn, M., Choy, E., ... & Edwards, C. J. (2010). The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review. Rheumatology, 49(2), 295-307. 9. Naranjo, A., Sokka, T., Descalzo, M. A., Calvo-Alén, J., Hørslev-Petersen, K., Luukkainen, R. K., ... & Pincus, T. (2008). Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study. Arthritis research & therapy, 10(2), 1-10. 10. Roubille, C., Richer, V., Starnino, T., McCourt, C., McFarlane, A., Fleming, P., ... & Haraoui, B. (2015). The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal antiinflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Annals of the rheumatic diseases, 74(3), 480-489.11. Shea, B., Swinden, M. V., Ghogomu, E. T., Ortiz, Z., Katchamart, W., Rader, T., ... & Tugwell, P. (2014). Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. The Journal of rheumatology, 41(6), 1049-1060. 12. Weinblatt, M. E., & Fraser, P. (1989). Elevated mean corpuscular volume as a predictor of hematologic toxicity due to methotrexate therapy. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 32(12), 1592-1596.