Abstract
Background Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with rheumatoid arthritis (RA). Flow-mediated (FMD) and nitrate-mediated dilation (NMD) are considered non-invasive methods to assess endothelial function and surrogate markers of subclinical atherosclerosis. Methods We performed a systematic review with meta-analysis and meta-regression of literature studies evaluating the impact of RA on FMD and NMD. Studies evaluating the relationship between RA and markers of CV risk (FMD and NMD) were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. The random-effect method was used for analyses and results were expressed as mean difference (MD). Results A total of 20 studies (852 RA patients, 836 controls) were included in the final analysis. In detail, 20 studies with data on FMD (852 cases, 836 controls) and 5 studies with data on NMD (207 cases, 147 controls) were analyzed. Compared to controls, RA patients showed a significantly lower FMD (MD: - 2.16%; 95% CI: - 3.33, - 0.98; P = 0.0003), with no differences in NMD (MD: - 0.41%; 95% CI: - 2.89, 2.06; P = 0.74). Interestingly, a lower FMD (MD: - 2.00%; 95% CI: - 3.20, - 0.80; P = 0.001) and no differences in NMD (P = 0.49) were confirmed when excluding data on patients with early-RA. Meta-regression models showed that a more severe inflammatory status was associated with a more significant impairment in FMD. Conclusions RA patients show impaired FMD, which is currently considered an independent predictor of CV events. The presence of endothelial dysfunction in RA should be taken into account to plan adequate prevention strategies and therapeutic approaches.
| Original language | English |
|---|---|
| Pages (from-to) | 835-842 |
| Number of pages | 8 |
| Journal | European Journal of Internal Medicine |
| Volume | 26 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Dec 1 2015 |
Fingerprint
Keywords
- Cardiovascular risk
- Endothelial dysfunction
- Flow-mediated dilation
- Nitrate-mediated dilation
- Rheumatoid arthritis
ASJC Scopus subject areas
- Internal Medicine
Cite this
Clinical assessment of endothelial function in patients with rheumatoid arthritis : A meta-analysis of literature studies. / Di Minno, Matteo Nicola Dario; Ambrosino, Pasquale; Lupoli, Roberta; Di Minno, Alessandro; Tasso, Marco; Peluso, Rosario; Tremoli, Elena.
In: European Journal of Internal Medicine, Vol. 26, No. 10, 01.12.2015, p. 835-842.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical assessment of endothelial function in patients with rheumatoid arthritis
T2 - A meta-analysis of literature studies
AU - Di Minno, Matteo Nicola Dario
AU - Ambrosino, Pasquale
AU - Lupoli, Roberta
AU - Di Minno, Alessandro
AU - Tasso, Marco
AU - Peluso, Rosario
AU - Tremoli, Elena
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with rheumatoid arthritis (RA). Flow-mediated (FMD) and nitrate-mediated dilation (NMD) are considered non-invasive methods to assess endothelial function and surrogate markers of subclinical atherosclerosis. Methods We performed a systematic review with meta-analysis and meta-regression of literature studies evaluating the impact of RA on FMD and NMD. Studies evaluating the relationship between RA and markers of CV risk (FMD and NMD) were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. The random-effect method was used for analyses and results were expressed as mean difference (MD). Results A total of 20 studies (852 RA patients, 836 controls) were included in the final analysis. In detail, 20 studies with data on FMD (852 cases, 836 controls) and 5 studies with data on NMD (207 cases, 147 controls) were analyzed. Compared to controls, RA patients showed a significantly lower FMD (MD: - 2.16%; 95% CI: - 3.33, - 0.98; P = 0.0003), with no differences in NMD (MD: - 0.41%; 95% CI: - 2.89, 2.06; P = 0.74). Interestingly, a lower FMD (MD: - 2.00%; 95% CI: - 3.20, - 0.80; P = 0.001) and no differences in NMD (P = 0.49) were confirmed when excluding data on patients with early-RA. Meta-regression models showed that a more severe inflammatory status was associated with a more significant impairment in FMD. Conclusions RA patients show impaired FMD, which is currently considered an independent predictor of CV events. The presence of endothelial dysfunction in RA should be taken into account to plan adequate prevention strategies and therapeutic approaches.
AB - Background Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with rheumatoid arthritis (RA). Flow-mediated (FMD) and nitrate-mediated dilation (NMD) are considered non-invasive methods to assess endothelial function and surrogate markers of subclinical atherosclerosis. Methods We performed a systematic review with meta-analysis and meta-regression of literature studies evaluating the impact of RA on FMD and NMD. Studies evaluating the relationship between RA and markers of CV risk (FMD and NMD) were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. The random-effect method was used for analyses and results were expressed as mean difference (MD). Results A total of 20 studies (852 RA patients, 836 controls) were included in the final analysis. In detail, 20 studies with data on FMD (852 cases, 836 controls) and 5 studies with data on NMD (207 cases, 147 controls) were analyzed. Compared to controls, RA patients showed a significantly lower FMD (MD: - 2.16%; 95% CI: - 3.33, - 0.98; P = 0.0003), with no differences in NMD (MD: - 0.41%; 95% CI: - 2.89, 2.06; P = 0.74). Interestingly, a lower FMD (MD: - 2.00%; 95% CI: - 3.20, - 0.80; P = 0.001) and no differences in NMD (P = 0.49) were confirmed when excluding data on patients with early-RA. Meta-regression models showed that a more severe inflammatory status was associated with a more significant impairment in FMD. Conclusions RA patients show impaired FMD, which is currently considered an independent predictor of CV events. The presence of endothelial dysfunction in RA should be taken into account to plan adequate prevention strategies and therapeutic approaches.
KW - Cardiovascular risk
KW - Endothelial dysfunction
KW - Flow-mediated dilation
KW - Nitrate-mediated dilation
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=84950326484&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84950326484&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2015.10.016
DO - 10.1016/j.ejim.2015.10.016
M3 - Article
C2 - 26547241
AN - SCOPUS:84950326484
VL - 26
SP - 835
EP - 842
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
IS - 10
ER -