TY - JOUR
T1 - Progression of coronary artery atherosclerosis in rheumatoid arthritis
T2 - Comparison with participants from the Multi-Ethnic Study of Atherosclerosis
AU - Chung, Cecilia P.
AU - Giles, Jon T.
AU - Kronmal, Richard A.
AU - Post, Wendy S.
AU - Gelber, Allan C.
AU - Petri, Michelle
AU - Szklo, Moyses
AU - Detrano, Robert
AU - Budoff, Matthew J.
AU - Blumenthal, Roger S.
AU - Ouyang, Pamela
AU - Bush, David
AU - Bathon, Joan M.
N1 - Funding Information:
We thank the ESCAPE RA staff, Marilyn Towns, Michelle Jones, Patricia Jones, Marissa Hildebrandt, and Shawn Franckowiak, and the staff of the Johns Hopkins Bayview Medical Center General Clinical Research Center and the field center of the Baltimore MESA cohort and the MESA Coordinating Center at the University of Washington, Seattle for their efforts. We thank Drs. Uzma Haque, Clifton Bingham III, Carol Ziminski, Jill Ratain, Ira Fine, Joyce Kopicky-Burd, David McGinnis, Andrea Marx, Howard Hauptman, Achini Perera, Peter Holt, Alan Matsumoto, Megan Clowse, Gordon Lam and others for recommending their patients for this study. This study was supported by Grant Numbers AR050026-01 (JMB) and 1K23AR054112-01 (JTG) from the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases; a Clinical Investigator Fellowship Award from the Research and Education Foundation of the American College of Rheumatology (JTG); and the Johns Hopkins Bayview Medical Center General Clinical Research Center (Grant Number M01RR02719). Funding for this research was also made possible by the American College of Rheumatology Research and Education Foundation’s Within Our Reach: Finding a Cure for Rheumatoid Arthritis campaign (JMB) and the ACR/REF Ephraim P. Engleman Endowed Resident Research Preceptorship (CPC). MESA is funded by contracts N01-HC-95159 through N01-HC-95166 and N01-HC-95169 from the National Heart, Lung, and Blood Institute.
PY - 2013/9/25
Y1 - 2013/9/25
N2 - Introduction: In cross-sectional studies, patients with rheumatoid arthritis (RA) have higher coronary artery calcium (CAC) than controls. However, their rate of progression of CAC and the predictors of CAC progression have heretofore remained unknown.Methods: Incidence and progression of CAC were compared in 155 patients with RA and 835 control participants. The association of demographic characteristics, traditional cardiovascular risk factors, RA disease characteristics and selected inflammatory markers with incidence and progression of CAC were evaluated.Results: The incidence rate of newly detected CAC was 8.2/100 person-years in RA and 7.3/100 person-years in non-RA control subjects [IRR 1.1 (0.7-1.8)]. RA patients who developed newly detectable CAC were older (59±7 vs. 55±6 years old, p=0.03), had higher triglyceride levels (137±86 vs. 97±60 mg/dL, p=0.03), and higher systolic blood pressure (129±17 vs. 117±15 mm Hg, p=0.01) compared to those who did not develop incident CAC. Differences in blood pressure and triglyceride levels remained significant after adjustment for age (p<=0.05). RA patients with any CAC at baseline had a median rate of yearly progression of 21 (7-62) compared to 21 (5-70) Agatston units in controls. No statistical differences between RA progressors and RA non-progressors were observed for inflammatory markers or for RA disease characteristics.Conclusions: The incidence and progression of CAC did not differ between RA and non-RA participants. In patients with RA, incident CAC was associated with older age, higher triglyceride levels, and higher blood pressure, but not with inflammatory markers or RA disease characteristics.
AB - Introduction: In cross-sectional studies, patients with rheumatoid arthritis (RA) have higher coronary artery calcium (CAC) than controls. However, their rate of progression of CAC and the predictors of CAC progression have heretofore remained unknown.Methods: Incidence and progression of CAC were compared in 155 patients with RA and 835 control participants. The association of demographic characteristics, traditional cardiovascular risk factors, RA disease characteristics and selected inflammatory markers with incidence and progression of CAC were evaluated.Results: The incidence rate of newly detected CAC was 8.2/100 person-years in RA and 7.3/100 person-years in non-RA control subjects [IRR 1.1 (0.7-1.8)]. RA patients who developed newly detectable CAC were older (59±7 vs. 55±6 years old, p=0.03), had higher triglyceride levels (137±86 vs. 97±60 mg/dL, p=0.03), and higher systolic blood pressure (129±17 vs. 117±15 mm Hg, p=0.01) compared to those who did not develop incident CAC. Differences in blood pressure and triglyceride levels remained significant after adjustment for age (p<=0.05). RA patients with any CAC at baseline had a median rate of yearly progression of 21 (7-62) compared to 21 (5-70) Agatston units in controls. No statistical differences between RA progressors and RA non-progressors were observed for inflammatory markers or for RA disease characteristics.Conclusions: The incidence and progression of CAC did not differ between RA and non-RA participants. In patients with RA, incident CAC was associated with older age, higher triglyceride levels, and higher blood pressure, but not with inflammatory markers or RA disease characteristics.
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U2 - 10.1186/ar4314
DO - 10.1186/ar4314
M3 - Article
C2 - 24286380
AN - SCOPUS:84884519559
VL - 15
JO - Arthritis Research and Therapy
JF - Arthritis Research and Therapy
SN - 1478-6354
IS - 5
M1 - R134
ER -