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All Journal Indonesian Journal of Rheumatology
Pambudi, Joko Rilo
Indonesian Rheumatology Association
Medicine & Pharmacology

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Pathogenesis of atherosclerosis in rheumatoid arthritis Pambudi, Joko Rilo; Isbagio, Harry
Indonesian Journal of Rheumatology Vol 5, No 1 (2014)
Publisher : Indonesian Rheumatology Association

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Abstract

Increased morbidity and mortality in patients with rheumatoid arthritis (RA) is largely associated with cardiovascular disease. In this case, the factors that play a role is chronic inflammation. A chronic inflammatory associated with condition which accelerate atherosclerosis and increased cardiovascular morbidity and mortality. Inflammatory and atherogenic mediators have a role in pathogenesis of RA and atherosclerosis. Atherogenesis in RA start when cytokines from the inflamed synovial tissue are released into the systemic circulation. Circulating cytokines affects the function of other tissues such as adipose tissue, skeletal muscle, liver and vascular endothelium that would lead to proatherogenic transformation process such as insulin resistance, prothrombotic effects, pro-oxidative stress and endothelial dysfunction. Size, weight and durationof systemic inflammatory response in RA are the most important factor causing damage. IMT (Intima Media Thickness) measurement on common carotid arteries byB-mode ultrasound is a rapid non-invasive examination of the structural anatomy, reproducible and relatively low risks that are advantageous for assessing therisk of cardiovascular disease and monitoring disease progression.
Predictor Factors of Atherosclerosis and Atherosclerosis Plaque in Rheumatoid Arthritis Patients Pambudi, Joko Rilo; Isbagio, Harry; Mulyadi, Rahmad; Abdullah, Murdani
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Background: Atherosclerosis and cardiovascular diseases have been known as the cause of increasing mortality among rheumatoid arthritis (RA) patients. Carotid intima media thickness (CIMT) measurement by ultrasound has been used as surrogate marker of atherosclerosis and cardiovascular disease.Methods: A cross sectional study of 86 RA patients fulfills EULAR/ACR 2010 critera for RA was conducted to study proportion and predictor factors of atherosclerosis and atherosclerosis plaque in rheumatoid arthritis patients.Results: Atherosclerosis and plaque was found in 47,7% and 29 % of patients. Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo were associated with atherosclerosis in multivariate logistic regression analysis with OR 10.70 (95% CI: 2.93-39.10), 4.99 (95% CI: 1.15-21.61) and 3.66 (95% CI: 1.11-11.99) respectively. Whereas hypertension, presence of antiCCP antibody and age ≥ 40 yo, were associated with plaque formation with OR 3.96 (95% CI: 1.15-13.57), 3.20 (95% CI: 1.11-9.24) and 3.61 (95% CI: 1.03-12.63) respectively.Conclusions: Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo was the predictors ofatherosclerosis, while hypertension, presence of antiCCP antibody and age ≥ 40 yo was the predictors of atherosclerosis plaque.Key words: atherosclerosis, intima media thickness, predictor, rheumatoid arthritis, ultrasonography.
Co-Authors Harry Isbagio Murdani Abdullah Rahmad Mulyadi, Rahmad