Clinical assessment of endothelial function in patients with rheumatoid arthritis: A meta-analysis of literature studies

Matteo Nicola Dario Di Minno, Pasquale Ambrosino, Roberta Lupoli, Alessandro Di Minno, Marco Tasso, Rosario Peluso, Elena Tremoli

Research output: Contribution to journalArticle

23 Citations (Scopus)

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 languageEnglish
Pages (from-to)835-842
Number of pages8
JournalEuropean Journal of Internal Medicine
Volume26
Issue number10
DOIs
Publication statusPublished - Dec 1 2015

Fingerprint

Meta-Analysis
Rheumatoid Arthritis
Nitrates
Dilatation
PubMed
Atherosclerosis
Biomarkers
Databases
Morbidity
Mortality

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 journalArticle

Di Minno, Matteo Nicola Dario ; Ambrosino, Pasquale ; Lupoli, Roberta ; Di Minno, Alessandro ; Tasso, Marco ; Peluso, Rosario ; Tremoli, Elena. / Clinical assessment of endothelial function in patients with rheumatoid arthritis : A meta-analysis of literature studies. In: European Journal of Internal Medicine. 2015 ; Vol. 26, No. 10. pp. 835-842.
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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.",
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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

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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

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