Abstract
Background: Rheumatoid arthritis (RA) patients have a shorter life expectancy than the general population primarily due to cardiovascular comorbidities. Objectives: To characterize arterial aging in RA. Patients and Methods: Coronary calcium score (CCS) were available from 112 RA patients; out of these patients, follow-up CCS were measured for 54 randomly selected individuals. Control CCS were obtained from the MESA database (includes 6,000 < participants); arterial age was calculated from CCS. Results: RA patients were significantly older (10.45 ± 18.45 years, p < 0.001) in terms of the arterial age than the age-, gender-, and race-matched controls. The proportion of RA patients who had zero CCS was significantly less (p < 0.01) than that of those in the MESA reference group. Each disease year contributed an extra 0.395 years (p < 0.01) on the top of the normal aging process. However, the rate of the accelerated aging is not uniform, in the first years of the disease it is apparently faster. Smoking (p < 0.05), previous cardiovascular events (p < 0.05), and high blood pressure (p < 0.05) had additional significant effect on the aging process. In the follow-up study, inflammatory disease activity (CRP > 5 mg/L, p < 0.05) especially in smokers and shorter than 10 years of disease duration (p = 0.05) had the largest impact. Conclusion: Arterial aging is faster in RA patients than in control subjects, particularly in the first 10 years of the disease. Inflammation, previous cardiovascular events, and smoking are additional contributing factors to the intensified coronary atherosclerosis progression. These data support that optimal control of inflammation is essential to attenuate the cardiovascular risk in RA.
Highlights
Rheumatoid arthritis (RA) is a heterogeneous autoimmune condition; it affects 0.5–1% of the population and is associated with disability and systemic complications (Turesson et al, 2006; Prete et al, 2011; Das and Padhan, 2017)
calcium score (CCS) were measured in 112 RA patients; control CCS were obtained from the Multi-Ethnic Study of Atherosclerosis (MESA) database
Both histograms can be split into two parts
Summary
Rheumatoid arthritis (RA) is a heterogeneous autoimmune condition; it affects 0.5–1% of the population and is associated with disability and systemic complications (Turesson et al, 2006; Prete et al, 2011; Das and Padhan, 2017) Both genetic and environmental factors have a central role in the pathogenesis of the disease, and cigarette smoke is the strongest known environmental factor (McInnes and Schett, 2007; Baka et al, 2009; McInnes and Schett, 2011). There are data indicating that progression in CCS is associated with higher risk of myocardial infarction (Raggi et al, 2000; Raggi et al, 2003), and coronary artery calcification adds information to the prediction of overall mortality (Shaw et al, 2003). Rheumatoid arthritis (RA) patients have a shorter life expectancy than the general population primarily due to cardiovascular comorbidities
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