Rheumatoid Arthritis and the Ankle-Brachial Pressure Index: Any Association?

Year 2014, Volume: 39 Issue: 1, 83 - 90, 22.07.2014

Asso Fraidoon Raof Merza Kosar Mohammad Osama Shukir Muhammed Amin Rozhgar Abdullah

https://doi.org/10.17826/cutf.40676

Abstract

Purpose: Several studies tried to assess the influence of rheumatoid arthritis (RA) on peripheral arteries and found an association with later development of intimal thickness and atherosclerosis. We tried to uncover the prevalence of subclinical peripheral vascular disease (PVD) in rheumatoid arthritis patients. Materials and Methods: This case control-study had involved sixty patients who were diagnosed with rheumatoid. Forty age, gender, and body mass index-matched healthy individuals were selected as the control group. All participants were non-smokers, non-hypertensive, and non-diabetics and had a normal lipid profile. The presence of peripheral arterial disease was evaluated by measuring the ankle-brachial pressure index (ABPI) at the level of each artery of the lower limbs. An index of ≤0.9 was considered abnormal and a possible reflection of an underlying PVD. Results: Twenty three (38%) out of the 60 RA patients demonstrated one or more abnormal arteries while only 3 (7.5%) out of the 40 control individuals had abnormal results (p-value

Keywords

rheumatoid arthritis; ankle- brachial pressure index; peripheral vascular disease

Romatoid Artrit ve Ayak Bileği-Brakiyal Baskı Endeksi Arasında Herhangi Bir İlişki Var mı?

Abstract

Amaç: Çeşitli çalışmalar, periferal arterler üzerinde romatoid artrit etkisini (RA) değerlendirmeyi araştırmış ve intimal kalınlaşmanın geç gelişimi ve ateroskleroz arasında bir ilişki bulmuştur. Biz romatoid artrit hastalarında subklinik periferik damar hastalığının (PVD) yaygınlığını ortaya çıkarmayı denedik. Materyal ve Metod : Bu vaka kontrol çalışmasına romatoid tanısı almış 60 hasta dahil oldu. Kırk yaş, cinsiyet ve vücut kitle indeksi uyumlu sağlıklı bireyler kontrol grubu olarak seçildi. Tüm katılımcılar sigara içmeyen, hipertansif ve diyabet olmayan, normal lipid profiline sahip bireylerdi. Periferik arter hastalığı varlığı alt ekstremitenin her arter düzeyinde ayak bileği-kol basınç indeksi (ABPI) ölçülerek değerlendirildi. 0.9 ≤ indeks anormal olarak kabul edildi ve PVD" nin altında yatan olası bir yansıma olduğu düşünüldü. Bulgular: 40 kontrol bireyin sadece 3"ünün (% 7.5) anormal sonuçları (p-değeri

Keywords

Romatoid artrit, ayak bileği-kol basınç indeksi; periferik damar hastalığı

References

• Gabriel SE, Crowson CS, Maradit Kremers H, Doran MF, Turesson C, O’Fallon WM, et al. Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years. Arthritis Rheum. 2003;48:54
• Ward MM. Recent improvements in survival in patients with rheumatoid arthritis: better outcomes or different study designs? Arthritis Rheum. 2001;44:1467-9.
• Meune C, Touze E, Trinquart L, Allanore Y. High risk of clinical cardiovascular events in rheumatoid arthritis: levels of associations of myocardial infarction and stroke through a systematic review and meta-analysis. Archives of Cardiovascular Diseases. 2010;103; 253-61.
• Cavagna L, Caporali R, Bogliolo L, Montecucco C. Cardiovascular involvement in rheumatoid arthritis. Progressi in Reumatologia. 2002;3:72-6.
• Al-Qaisi MO, Nott DM, King DH, Kaddoura S, Ankle Brachial Pressure Index(ABPI): an update for practitioners. Vasc Health Risk Manag. 2009; 5:833
• Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315-24.
• Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206-52.
• National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:31434
• Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, et al. Management of hyperglycemia in Type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2006;29:1963-72.
• Schöder F, Diehm N, Kareem S, Ames M, Pira A, Zwettler U, et al. A modified calculation of anklebrachial pressure index is far more sensitive in the detection of peripheral arterial disease. J Vasc Surg. 2006;44:531-6.
• Drosos A. Epidemiology of rheumatoid arthritis. Autoimmun Rev. 2004;3:20-2.
• Symmons D, Barrett E, Bankhead C, Scott DG, Silman AJ. The occurrence of rheumatoid arthritis in the United Kingdom: results from the Norfolk Arthritis Register. Br J Rheumatol. 1994;33:735-39.
• Bacon PA, Stevens RJ, Carruthers DM, Young SP, Kitas GD. Accelerated atherogenesis in autoimmune rheumatic diseases. Autoimmun Rev. 2002;1:338
• Cunha VR, Brenol CV, Brenol JC, Xavier RM. Rheumatoid arthritis and metabolic syndrome. Revista Brasileira de Reumatologia. 2011;51:260-8.
• Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination survey 1999-2000.Circulation. 2004;110:738-43.
• Dormandy JA. Epidemiology and natural history of arterial diseases of lower limbs. Rev Prat 1995;45:32-36.
• Hirsch AT, Hiatt WR, PARTNERS Steering Committee. PAD awareness, risk, and treatment: new resources for survival-the USA PARTNERS program. Vasc Med. 2001;6:9-12.
• Hirsch AT, Halverson SL, treat-Jacobson D. The Minnesota Regional Peripheral Arterial Disease Screening Program: toward a definition of community standards of care. Vasc Med. 2001;6:87
• Rose GA. The diagnosis of ischemic heart pain and intermittent claudication in field survey. Bull Health World Organ. 1962:27:645-58.
• Criqui MH, Fronek A, Klauber MA, Barrett-Connor E, Gabriel S. The sensitivity, the specificity, the predictive value, of traditional clinical evaluation of peripheral artery disease: results from non- invasive testing in a defined population. Circulation. 1985;71:516-22.
• Marinelli MR, Beach KW, Glass MJ, Primozich JF, Strandness DE. Non-invasive testing vs clinical evaluation of arterial disease: a prospective study. JAMA. 1979;241:2031-4.
• Yao ST, Hobbs JT, Irvine WT, ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg. 1969;56:676-9.
• Kimberly P, Liang MD, Kelly V, Eric L, Matteson MD, Robyn L, et al. Incidence of non-cardiac vascular disease in Rheumatoid Arthritis and relationship to extraarticular disease manifestations. Arthritis Rheum. 2006;54:642-8.
• Kaplan MJ, McCune WJ. New evidence for vascular disease in patients with early Rheumatoid Arthritis. Lancet. 2003;361:1068-9.
• Ray SA, Srodon PD, Taylor RS, Dormandy JA. Reliability of anklebrachial pressure index measurement by junior doctors. Br J Surg. 1994;81:188-90.
• Del Rincón I, Williams K, Stern MP, Freeman GL, O'Leary DH, Escalante A. Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects. Arthritis Rheum. 2003;48:1833-40.
• Alkaabi J K, Ho M, Levison R, Pullar T, Belch JJ. Rheumatoid arthritis and macrovascular disease. Rheumatology. 2003;42:292-7.
• Ahmad S, Garg S, Dhar M, Srivastava S, Biswas D, Barthwal SP, et al. Predictors of atherosclerosis in rheumatoid arthritis.Vasa. 2012;41:353-9.
• Miasoedova EE, Obzherina SV, Sviatova ND, Miasoedova SE. [Predictors of cardiovascular and cerebral complications in patients with rheumatoid arthritis]. Klin Med (Mosk). 2012;90:46-51.
• Kerola AM, Kauppi MJ, Kerola T, Nieminen TV. How early in the course of rheumatoid arthritis does the excess cardiovascular risk appear? Ann Rheum Dis. 2012;71:1606-15.
• Guellec D, Bressollette L, Gueguen F, Jousse-Joulin S, Marhadour T, Devauchelle-Pensec V, Saraux A. Is routine ankle-brachial pressure index evaluation useful in rheumatoid arthritis? Joint Bone Spine. 2013;80:111-3.
• Kim YS, Sung YK, Choi CB, Uhm WS, Kim TH, Shin JH, et al. The major determinants of arterial stiffness in Korean patients with rheumatoid arthritis are age and systolic blood pressure, not disease-related factors. Rheumatol Int. 2012;32:3455-61.
• Yazışma Adresi / Address for Correspondence: Osama Shukir Muhammed Amin Sulaimaniya City Post-Office, PO BOX 196, Sulaimaniya City, IRAQ Mobile: [phone]
• E-mail: [e-mail] geliş tarihi/received :28.08.2012 kabul tarihi/accepted:25.09.2012