rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2009-1314rsp-1196Research ArticleСтатьиArticlesОпределение кальция в коронарных артериях: новые возможности стратификации риска развития сердечно-сосудистых осложнений у пациентов с аутоиммунными заболеваниямиCalcium evaluation in coronary arteries: new possibilities of cardiovascular complications risk stratification in patients with autoimmune diseasesНовиковаД. С.NovikovaD S-ПопковаТ. В.PopkovaT V-MachE SMachE S-НасоновЕвгений ЛьвовичNasonovE L-200915062009473№3 (2009)6066Copyright © Новикова Д.С., Попкова Т.В., Mach E.S., Насонов Е.Л., 20092009Новикова Д.С., Попкова Т.В., Mach E.S., Насонов Е.Л.Novikova D.S., Popkova T.V., Mach E.S., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1196

Сохраняющееся снижение продолжительности жизни больных с аутоиммунными заболевания- ми, несмотря на непрерывное совершенствование методов диагностики и лечения этих пациентов, остается актуальной проблемой современной ревматологии. Одной из основных причин летальности при ревматических заболеваниях (РЗ) являются сердечно-сосудистые катастрофы (инфаркт миокарда, инсульт, внезапная сердечная смерть), обусловленные ранним развитием и быстрым прогрессированием атеросклеротического поражения сосудов [1]. В исследованиях последних лет показано, что увеличение риска развития сердечно-сосудистых осложнений (ССО) при РЗ связано не только с традиционными факторами риска (ТФР), но и с иммуновоспалительными механизмами, лежащими в основе патогенеза РЗ и атеросклероза [2,3]. Полагают, что воспаление способствует отложению липидов в сосудистой стенке, имеет существенное патогенетические значение в «дестабилизации» атеросклеротической бляшки (АТБ) и в развитии атеротромботических осложнений [4,5].

References<div><p>Hall F.C, Dalbeth N. Disease modification and cardiovascular risk reduction: two sides of the same coin? Rheumatology, 2005, 44, 1473 – 82.</p><p>Leuven S.I, Franssen R, Kastelein J.J. et al. Systemic inflammation as a risk factor for atherothrombosis. Rheumatology, 2008, 47, 3 – 7.</p><p>Насонов Е.Л. Иммунологические маркеры атеросклероза. Тер. архив, 2002, 5, 80 – 5.</p><p>Ross R. Atherosclerosis – an inflammatory disease. N. Engl. J. Med., 1999, 340, 115 – 26.</p><p>Libby P, Ridker P.M, Maseri A. Inflammation and atherosclerosis. Circulation, 2002, 105, 1135 – 43.</p><p>Ревматология. Нац. руководство. Под ред. Насонова Е.Л, Насоновой В.А. М., Гэотар-Медиа, 2008, 647 – 60.</p><p>Goodson N.J, Wiles N.J, Lunt M. et al. Mortality in early inflammatory polyarthritis. Cardiovascular mortality is increased in seropositive patients. Arthritis Rheum., 2002, 46, 2010 – 9.</p><p>Mansi S, Meilahn E, Rairie J. et al. Age specific incidence rates of myocardial infarction angina in women with systemic lupus erythematosus: comparison with the Framingem study. Am. J. Epidemiol., 1997, 145, 408 – 15.</p><p>Синицын В.Е., Воронов Д.А., Морозов С.П. Степень кальциноза коронарных артерий как прогностический фактор осложнений сердечно-сосудистых заболеваний без клинических проявлений: результаты метаанализа. Тер. архив, 2006, 9, 22 – 7.</p><p>Синицын В.Е., Терновой С.К. Новая роль мультиспиральной компьтерной томографии в диагностике болезней сердца и сосудов. Тер. архив, 2007, 4, 5 – 10.</p><p>Федотенков И.С., Веселова Т.Н., Терновой С.К., Синицын В.Е. Роль мультиспиральной компьютерной томографии в диагностике кальциноза коронарных артерий. Кардиол. вестник 2007, 2, 3 – 8.</p><p>Терновой С.К., Федотенков И.С., Гагарина Н. В. и соавт. Количественный анализ уровня кальциноза коронарных артерий: сравнение информативности мультиспиральной компьютерной томографии и электронно-лучевой томографии. Тер.архив, 2006, 12, 15 – 9.</p><p>Arad Y., Goodman K.J., Roth M. et al. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. JACC, 2005, 46 (1), 158 – 65.</p><p>Arad Y., Spadaro L.A., Goodman K. et al. Prediction of coronary events with electron-beam CT. JACC, 2000, 36, 1253 – 60.</p><p>Kondos G.T., Hoff J.A., Sevrukov A. et al. Electronbeam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymp- tomatic low- to intermediate-risk adults. Circulation, 2003, 107 (20), 2571 – 6.</p><p>Rumberger J.A., Brundage B.H., Rader D.J., Kondos G. Electron beam computed tomographic coronary calcium scaning: a review and quidelines for use in asymptomatic persons. Mayo Clin. Proc., 1999, 74, 243 – 52.</p><p>Budoff M.J., Shaw L.J., Liu S.T. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. JACC, 2007, 49 (18), 1860 – 70.</p><p>Geluk C.A., Dikkers R., Perik P.J. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease. Eur. Radiol. 2008, 8 (2), 244 – 52.</p><p>Белькинд М.Б., Синицин В.Е., Лякишев А.А. и соавт. Коронарный кальций и лечение статинами. Тер. архив, 2006, 4, 53 – 6.</p><p>Gazi I.F, Boumpas D.T, Mikhailidis D. et al. Clustering of cardiovascular risk factors in rheumatoid arthritis: the rationale for using statins. Clin. Exp. Rheumatol., 2007, 25, 102 – 11.</p><p>Westerweel P.E, Luyten R, Koomans H. et al. Premature atherosclerotic cardiovascular disease in systemic lupus erythematosus. Arthritis Rheum., 2007, 56 (5), 1384 – 96.</p><p>Chung C.P., Oeser A., Raggi P. Increased coronaryartery atherosclerosis in rheumatoid arthritis: rela- tionship to disease duration and cardiovascular risk factors. Arthritis Rheum., 2005, 52 (10), 3045 – 53.</p><p>Kao A.H., Krisnaswami S., Cunningham A. Subclinical Coronary Artery Calcification and Relationship to Disease Duration in Women with Rheumatoid Arthritis J. Rheumatol., 2008, 35, 61 – 9.</p><p>Papadopoulos N.G, Alamanos Y, Voulgari P.V. et al. Does cigarette smoking influence disease expression, activity and severity in early rheumatoid arthritis patients? Clin. Exp. Rheumatol., 2005, 23, 861 – 6.</p><p>J ckel K.H., Lehmann N., Jaeger B.R. Smoking cessation and subclinical atherosclerosis-Results from the Heinz Nixdorf Recall Study. Atherosclerosis, 2008, Jul 2. [Epub ahead of print]</p><p>Chung C.P., Oeser A., Avalos I. Utility of the Framingham risk score to predict the presence of coronary atherosclerosis in patients with rheumatoid arthritis. Arthritis Res. Ther., 2006, 8 (6), R186.</p><p>Chung C. P., Oeser A., Joseph F. Prevalence of the metabolic syndrome is increased in rheumatoid arthri- tis and is associated with coronary atherosclerosis. Atherosclerosis, 2008, 196 (2), 756 – 63.</p><p>Chen K., Lindsey J.B., Khera A. Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart Study.Diab. Vasc. Dis. Res., 2008, 5 (2), 96 – 101.</p><p>Gonzalez-Gay M.A, De Matias J.M, Gonzalez- Juanatey C. et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin. Exp. Rheumatol., 2006, 24, 83 – 6.</p><p>Avalos I., Chung C.P., Oeser A. Increased Augmentation Index in Rheumatoid Arthritis and Its Relationship to Coronary Artery Atherosclerosis J. Rheumatol., 2007, 34, 2388 – 94.</p><p>van Popele N.M., Mattace-Raso F.U., Vliegenthart R. Aortic stiffness is associated with atherosclerosis of the coronary arteries in older adults: the Rotterdam Study. J. Hypertens., 2006, 24(12), 2371 – 6.</p><p>Asanuma Y., Chung C.P., Oeser A. Serum osteoprotegerin is increased and independently associated with coronary-artery atherosclerosis in patients with rheumatoid arthritis. Atherosclerosis, 2007, 195(2), 135 – 41.</p><p>Montecucco F. and F. Mach Common inflammatory mediators orchestrate pathophysiological pro- cesses in. rheumatoid arthritis and atherosclerosis J. Rheumatology, 2009, 48, 11 – 22.</p><p>Kao A.H., Wasko M.C., Krishnaswami S. C-reactive protein and coronary artery calcium in asymptomatic women with systemic lupus erythematosus or rheu- matoid arthritis. Am. J. Cardiol., 2008, 102 (6), 755–60.</p><p>Asanuma Y., Oeser A., Ayumi K. Premature Coronary Artery Atherosclerosis in Systemic Lupus Erythematosus. N. Engl. J. Med., 2003, 349, 2407 – 15.</p><p>Asanuma Y., Chung C.P., Oeser A. Increased Concentration of Proatherogenic Inflammatory Cytokines in Systemic Lupus Erythematosus: Relationship to Cardiovascular Risk Factors J. Rheumatol., 2006, 33, 539 – 45.</p><p>Rho Y.H., Chung C.P., Oeser A. Novel Cardiovascular Risk Factors in Premature Coronary Atherosclerosis Associated with Systemic Lupus Erythematosus. J. Rheumatol., 2008, 35 (9), 1789 – 94.</p><p>de Carvalho J.F., Hanaoka B., Szyper-Kravitz M., Shoenfeld Y. C-reactive protein and its implications in systemic lupus erythematosus. Acta Reumatol. Port., 2007, 32, 317 – 22.</p><p>Lee S.S., Singh S., Link K. et al. High-Sensitivity C-Reactive Protein as an Associate of Clinical Subsets and Organ Damage in Systemic Lupus Erythematosus. Semin. Arthritis Rheum., 2008, 38 (1), 41 – 54.</p><p>Suh C.H., Kim H.A. Cytokines and their receptors as biomarkers of systemic lupus erythematosus. Expert Rev. Mol. Diagn., 2008, 8, 189 – 98.</p><p>Chun H.Y., Chung J.W., Yun J.M. et al. Cytokine IL-6 and IL-10 as biomarkers in systemic lupus ery- thematosus. J. Clin. Immunol., 2007, 27, 461 – 5.</p><p>Woods A., Brull D.J., Humphries S.E. et al. Genetics of inflammation and risk of coronary artery disease: the central role of interleukin-6. Eur. Heart J. 2000, 21, 1574 – 83.</p><p>Saremi A., Anderson R.J., Luo P. Association between IL-6 and the extent of coronary atherosclerosis in the veterans affairs diabetes trial (VADT). Atherosclerosis, 2008, Epub ahead of print.</p><p>Von Feldt J.M., Scalzi L.V. Homocysteine Levels and Disease Duration Independently Correlate With Coronary Artery Calcification in Patients With Systemic Lupus Erythematosus. Arthritis Rheum., 2006, 54 (7), 2220 – 7.</p><p>Кардиология. Нац. руководство. Под ред. Ю.Н. Беленкова, Р.Г. Оганова, М.: Гэотар – Медиа, 2007. – 1232с.</p><p>Orakzai S.H., Nasir K., Blaha M. Non-HDL cholesterol is strongly associated with coronary artery calcification in asymptomatic individuals. Atherosclerosis, 2009, 202 (1), 289 – 95.</p><p>Solus J., Chung C.P., Oeser A. Amino-terminal fragment of the prohormone brain-type natriuretic peptide in rheumatoid arthritis. J. Rheumatol., 2008, 35 (7), 1314 – 9.</p><p>Chung C.P., Solus J.F., Oeser A. N-terminal pro-brain natriuretic peptide in systemic lupus erythematosus: relationship with inflammation, augmentation index, and coronary calcification. Arthritis Rheum., 2008, 58 (9), 2662 – 9.</p></div><br /><div><p>Hall F.C, Dalbeth N. Disease modification and cardiovascular risk reduction: two sides of the same coin? Rheumatology, 2005, 44, 1473 – 82.</p><p>Leuven S.I, Franssen R, Kastelein J.J. et al. Systemic inflammation as a risk factor for atherothrombosis. Rheumatology, 2008, 47, 3 – 7.</p><p>Насонов Е.Л. Иммунологические маркеры атеросклероза. Тер. архив, 2002, 5, 80 – 5.</p><p>Ross R. Atherosclerosis – an inflammatory disease. N. Engl. J. Med., 1999, 340, 115 – 26.</p><p>Libby P, Ridker P.M, Maseri A. Inflammation and atherosclerosis. Circulation, 2002, 105, 1135 – 43.</p><p>Ревматология. Нац. руководство. Под ред. Насонова Е.Л, Насоновой В.А. М., Гэотар-Медиа, 2008, 647 – 60.</p><p>Goodson N.J, Wiles N.J, Lunt M. et al. Mortality in early inflammatory polyarthritis. Cardiovascular mortality is increased in seropositive patients. Arthritis Rheum., 2002, 46, 2010 – 9.</p><p>Mansi S, Meilahn E, Rairie J. et al. Age specific incidence rates of myocardial infarction angina in women with systemic lupus erythematosus: comparison with the Framingem study. Am. J. Epidemiol., 1997, 145, 408 – 15.</p><p>Синицын В.Е., Воронов Д.А., Морозов С.П. Степень кальциноза коронарных артерий как прогностический фактор осложнений сердечно-сосудистых заболеваний без клинических проявлений: результаты метаанализа. Тер. архив, 2006, 9, 22 – 7.</p><p>Синицын В.Е., Терновой С.К. Новая роль мультиспиральной компьтерной томографии в диагностике болезней сердца и сосудов. Тер. архив, 2007, 4, 5 – 10.</p><p>Федотенков И.С., Веселова Т.Н., Терновой С.К., Синицын В.Е. Роль мультиспиральной компьютерной томографии в диагностике кальциноза коронарных артерий. Кардиол. вестник 2007, 2, 3 – 8.</p><p>Терновой С.К., Федотенков И.С., Гагарина Н. В. и соавт. Количественный анализ уровня кальциноза коронарных артерий: сравнение информативности мультиспиральной компьютерной томографии и электронно-лучевой томографии. Тер.архив, 2006, 12, 15 – 9.</p><p>Arad Y., Goodman K.J., Roth M. et al. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. JACC, 2005, 46 (1), 158 – 65.</p><p>Arad Y., Spadaro L.A., Goodman K. et al. Prediction of coronary events with electron-beam CT. JACC, 2000, 36, 1253 – 60.</p><p>Kondos G.T., Hoff J.A., Sevrukov A. et al. Electronbeam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymp- tomatic low- to intermediate-risk adults. Circulation, 2003, 107 (20), 2571 – 6.</p><p>Rumberger J.A., Brundage B.H., Rader D.J., Kondos G. Electron beam computed tomographic coronary calcium scaning: a review and quidelines for use in asymptomatic persons. Mayo Clin. Proc., 1999, 74, 243 – 52.</p><p>Budoff M.J., Shaw L.J., Liu S.T. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. JACC, 2007, 49 (18), 1860 – 70.</p><p>Geluk C.A., Dikkers R., Perik P.J. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease. Eur. Radiol. 2008, 8 (2), 244 – 52.</p><p>Белькинд М.Б., Синицин В.Е., Лякишев А.А. и соавт. Коронарный кальций и лечение статинами. Тер. архив, 2006, 4, 53 – 6.</p><p>Gazi I.F, Boumpas D.T, Mikhailidis D. et al. Clustering of cardiovascular risk factors in rheumatoid arthritis: the rationale for using statins. Clin. Exp. Rheumatol., 2007, 25, 102 – 11.</p><p>Westerweel P.E, Luyten R, Koomans H. et al. Premature atherosclerotic cardiovascular disease in systemic lupus erythematosus. Arthritis Rheum., 2007, 56 (5), 1384 – 96.</p><p>Chung C.P., Oeser A., Raggi P. Increased coronaryartery atherosclerosis in rheumatoid arthritis: rela- tionship to disease duration and cardiovascular risk factors. Arthritis Rheum., 2005, 52 (10), 3045 – 53.</p><p>Kao A.H., Krisnaswami S., Cunningham A. Subclinical Coronary Artery Calcification and Relationship to Disease Duration in Women with Rheumatoid Arthritis J. Rheumatol., 2008, 35, 61 – 9.</p><p>Papadopoulos N.G, Alamanos Y, Voulgari P.V. et al. Does cigarette smoking influence disease expression, activity and severity in early rheumatoid arthritis patients? Clin. Exp. Rheumatol., 2005, 23, 861 – 6.</p><p>J ckel K.H., Lehmann N., Jaeger B.R. Smoking cessation and subclinical atherosclerosis-Results from the Heinz Nixdorf Recall Study. Atherosclerosis, 2008, Jul 2. [Epub ahead of print]</p><p>Chung C.P., Oeser A., Avalos I. Utility of the Framingham risk score to predict the presence of coronary atherosclerosis in patients with rheumatoid arthritis. Arthritis Res. Ther., 2006, 8 (6), R186.</p><p>Chung C. P., Oeser A., Joseph F. Prevalence of the metabolic syndrome is increased in rheumatoid arthri- tis and is associated with coronary atherosclerosis. Atherosclerosis, 2008, 196 (2), 756 – 63.</p><p>Chen K., Lindsey J.B., Khera A. Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart Study.Diab. Vasc. Dis. Res., 2008, 5 (2), 96 – 101.</p><p>Gonzalez-Gay M.A, De Matias J.M, Gonzalez- Juanatey C. et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin. Exp. Rheumatol., 2006, 24, 83 – 6.</p><p>Avalos I., Chung C.P., Oeser A. Increased Augmentation Index in Rheumatoid Arthritis and Its Relationship to Coronary Artery Atherosclerosis J. Rheumatol., 2007, 34, 2388 – 94.</p><p>van Popele N.M., Mattace-Raso F.U., Vliegenthart R. Aortic stiffness is associated with atherosclerosis of the coronary arteries in older adults: the Rotterdam Study. J. Hypertens., 2006, 24(12), 2371 – 6.</p><p>Asanuma Y., Chung C.P., Oeser A. Serum osteoprotegerin is increased and independently associated with coronary-artery atherosclerosis in patients with rheumatoid arthritis. Atherosclerosis, 2007, 195(2), 135 – 41.</p><p>Montecucco F. and F. Mach Common inflammatory mediators orchestrate pathophysiological pro- cesses in. rheumatoid arthritis and atherosclerosis J. Rheumatology, 2009, 48, 11 – 22.</p><p>Kao A.H., Wasko M.C., Krishnaswami S. C-reactive protein and coronary artery calcium in asymptomatic women with systemic lupus erythematosus or rheu- matoid arthritis. Am. J. Cardiol., 2008, 102 (6), 755–60.</p><p>Asanuma Y., Oeser A., Ayumi K. Premature Coronary Artery Atherosclerosis in Systemic Lupus Erythematosus. N. Engl. J. Med., 2003, 349, 2407 – 15.</p><p>Asanuma Y., Chung C.P., Oeser A. Increased Concentration of Proatherogenic Inflammatory Cytokines in Systemic Lupus Erythematosus: Relationship to Cardiovascular Risk Factors J. Rheumatol., 2006, 33, 539 – 45.</p><p>Rho Y.H., Chung C.P., Oeser A. Novel Cardiovascular Risk Factors in Premature Coronary Atherosclerosis Associated with Systemic Lupus Erythematosus. J. Rheumatol., 2008, 35 (9), 1789 – 94.</p><p>de Carvalho J.F., Hanaoka B., Szyper-Kravitz M., Shoenfeld Y. C-reactive protein and its implications in systemic lupus erythematosus. Acta Reumatol. Port., 2007, 32, 317 – 22.</p><p>Lee S.S., Singh S., Link K. et al. High-Sensitivity C-Reactive Protein as an Associate of Clinical Subsets and Organ Damage in Systemic Lupus Erythematosus. Semin. Arthritis Rheum., 2008, 38 (1), 41 – 54.</p><p>Suh C.H., Kim H.A. Cytokines and their receptors as biomarkers of systemic lupus erythematosus. Expert Rev. Mol. Diagn., 2008, 8, 189 – 98.</p><p>Chun H.Y., Chung J.W., Yun J.M. et al. Cytokine IL-6 and IL-10 as biomarkers in systemic lupus ery- thematosus. J. Clin. Immunol., 2007, 27, 461 – 5.</p><p>Woods A., Brull D.J., Humphries S.E. et al. Genetics of inflammation and risk of coronary artery disease: the central role of interleukin-6. Eur. Heart J. 2000, 21, 1574 – 83.</p><p>Saremi A., Anderson R.J., Luo P. Association between IL-6 and the extent of coronary atherosclerosis in the veterans affairs diabetes trial (VADT). Atherosclerosis, 2008, Epub ahead of print.</p><p>Von Feldt J.M., Scalzi L.V. Homocysteine Levels and Disease Duration Independently Correlate With Coronary Artery Calcification in Patients With Systemic Lupus Erythematosus. Arthritis Rheum., 2006, 54 (7), 2220 – 7.</p><p>Кардиология. Нац. руководство. Под ред. Ю.Н. Беленкова, Р.Г. Оганова, М.: Гэотар – Медиа, 2007. – 1232с.</p><p>Orakzai S.H., Nasir K., Blaha M. Non-HDL cholesterol is strongly associated with coronary artery calcification in asymptomatic individuals. Atherosclerosis, 2009, 202 (1), 289 – 95.</p><p>Solus J., Chung C.P., Oeser A. Amino-terminal fragment of the prohormone brain-type natriuretic peptide in rheumatoid arthritis. J. Rheumatol., 2008, 35 (7), 1314 – 9.</p><p>Chung C.P., Solus J.F., Oeser A. N-terminal pro-brain natriuretic peptide in systemic lupus erythematosus: relationship with inflammation, augmentation index, and coronary calcification. Arthritis Rheum., 2008, 58 (9), 2662 – 9.</p></div><br />

The authors declare that there are no conflicts of interest present.