Risk factors of atherosclerosis and clinical and morphological comparisons in systemic vasculitides
https://doi.org/10.14412/1995-4484-2012-1106
Abstract
Objective: to study the incidence rates of angina, myocardial infarction (MI), stroke, and the frequency of endovascular interventions in patients with systemic vasculitides, and the incidence rate of atherosclerosis according to autopsy data. Subjects and methods. Three hundred and twenty-one patients with systemic vasculitides: Wegener's granulomatosis (n = 138), Takayasu's arteritis (n = 79), polyarteritis nodosum (n = 55), and Churg-Strauss syndrome (n = 49) were examined; 55 autopsies were analyzed in patients with the above diseases. Results. Fifty-one (15.6%) of the 321 patients were diagnosed as having cardiovascular diseases (CVD): angina pectoris (7.1%) and MI (3.1%) and endovascular interventions (0.9%). The risk of cardiovascular events was found to be associated with traditional risk factors, such as male gender and age. Arterial hypertension, hypercholesterolaemia, and increased serum creatinine were more frequently detected in the CVD group that showed no significant differences from the non-CVD group. According to autopsy results, atherosclerosis was identified in the patients with Wegener's granulomatosis (52%), Takayasu's arteritis (50%), polyarteritis nodosum (52.6%), and Churg-Strauss syndrome (57.1%). Conclusion. CVD and atherosclerosis are common in systemic vasculitides, which requires the traditional risk factors of atherosclerosis to be actively corrected.
About the Authors
Leonid Aleksandrovich StrizhakovS V Moiseyev
E A Kogan
V E Ditterle
E N Semenkova
E I Kuznetsova
References
1. <div><p>Van Oostrom A.J., van Wijk J., Cabezaz M.C. Lipaemia, inflammation and atherosclerosis: novel opportunities in the understanding and treatment of atherosclerosis. Drugs 2004;64:19-41.</p><p>Everett B.M., Kurth T., Buring J.E., Ridker P.M. The relative strength of C-reactive protein and lipid levels as determinants of ischemic stroke compared with coronary heart disease in women. J Am Coll Cardiol 2006;48(11):2235-42.</p><p>Ridker P.M., Rifai N., Pfeffer M. et al. Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction. Circulation 2000;101:2149-53.</p><p>Biasucci L.M., Vitelli A., Liuzzo G. et al. Elevated levels of interleukin-6 in unstable angina. Circulation 1996;94:874-7.</p><p>Frostegard J. Atherosclerosis in patients with autoimmune disorders. Arterioscler Thromb Vasc Biol 2005;25:1776-85.</p><p>Ward M. Premature morbidity from cardiovascular and cerebrovascular diseases in women with systemic lupus erythematosus. Arthr Rheum 1999;42:338-46.</p><p>Серикова С.Ю., Козловская Н.Л., Шилов Е.М. Волчаночный нефрит как фактор риска атеросклероза у больных системной красной волчанкой. Тер арх 2008;6:52-8.</p><p>Meune C., Touze E., Trinqurte L. et al. Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and metaanalisis of cohort studies. Rheumatology 2009;48(10):1309-13.</p><p>Peters M., Symmons D., McCarey D. et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other types of inflammatory arthritis - TASK FORCE «Cardiovascular risk management in RA». Ann Rheum Dis 2010;69(2):325-31.</p><p>Попкова Т.В., Новикова Д.С., Насонов Е.Л. Атеросклероз при ревматических заболеваниях. В кн.: Ревматология: Клинические рекомендации. M.: ГЭОТАР-Медиа, 2010; 678-702.</p><p>Shoenfeld Y., Gerli R., Dorial A. et al. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation 2005;112:3337-47.</p><p>Шилкина Н.П., Дряженкова И.В. Системные васкулиты и атеросклероз. Тер арх 2007;79(3):84-92</p><p>Raza K., Thambyrajah J., Townend J. et al. Suppression of inflammation in primary systemic vasculitis restores vascular endothelial function: lessons for atherosclerotic disease? Circulation 2000;102:1470-2.</p><p>Filer A., Gardner-Medwin J., Thambyrajah J. et al. Diffuse endothelial dysfunction is common to ANCA associated systemic vasculitis and polyarteritis nodosa. Ann Rheum Dis 2003;62:162-7.</p><p>Booth A., Jayne D., Kharbanda R. et al. Infliximab improves endothelial dysfunction in systemic vasculitis: a model of vascular inflammation. Circulation 2004;109:1718-23.</p><p>De Leeuw K., Sanders J., Stegeman C. et al. Accelerated atherosclerosis in patients with Wegener's granulomatosis. Ann Rheum Dis 2005;64:753-9.</p><p>Booth A., Wallace S., McEniery C.M. et al. Inflammation and arterial stiffness in systemic vasculitis: a model of vascular inflammation. Arthr Rheum 2004;50:581-8.</p><p>Chironi G., Pagnoux C., Simon A. et al. Increased prevalence of subclinical atherosclerosis in patients with small-vessel vasculitis. Heart 2007;93:96-9.</p><p>Faurschou M., Mellemkjaer L., Sorensen I. et al. Increased morbidity from ischemic heart disease in patients with Wegener's granulomatosis. Arthr Rheum 2009;60(4):1187-92.</p><p>Гафаров В.В., Акимова Е.В., Кузнецов В.А. Динамика распространенности ишемической болезни сердца и сердечнососудистой смерти в открытой популяции Тюмени. Кардиология 2006;46(1):14-8.</p><p>Тожиев М.С., Норбеков М.С., Шестов Д.Б. и др. Распространенность ишемической болезни сердца, основных факторов риска ее развития и эффективность многолетней многофакторной профилактики на предприятиях в ряде регионов России. Тер арх 2004;76(1):33-8.</p><p>Korantzopoulos P., Papaioannides D., Siogas K. The heart in Wegener's granulomatosis. Cardiology 2004;102:7-10.</p><p>Lazarus M., Khurana R., Sethi A., Naughton M. Wegener's granulomatosis presenting with an acute ST-elevation myocardial infarct (STEMI). Rheumatology (Oxford) 2006;45:916-8.</p></div><br />
Review
For citations:
Strizhakov L.A., Moiseyev S.V., Kogan E.A., Ditterle V.E., Semenkova E.N., Kuznetsova E.I. Risk factors of atherosclerosis and clinical and morphological comparisons in systemic vasculitides. Rheumatology Science and Practice. 2012;50(4):18-23. (In Russ.) https://doi.org/10.14412/1995-4484-2012-1106
Views:
1024
Email this article 