Mong Nikolett, Tarjanyi Zoltan, Tothfalusi Laszlo, Bartykowszki Andrea, Nagy Aniko Ilona, Szekely Anett, Becker David, Maurovich-Horvat Pal, Merkely Bela, Nagy Gyorgy
Polyclinic of Hospitaller Brothers of St. John of God, Budapest, Hungary.
Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Front Pharmacol. 2020 Nov 26;11:523962. doi: 10.3389/fphar.2020.601344. eCollection 2020.
Rheumatoid arthritis (RA) patients have a shorter life expectancy than the general population primarily due to cardiovascular comorbidities. To characterize arterial aging in RA. Coronary calcium score (CCS) were available from 112 RA patients; out of these patients, follow-up CCS were measured for 54 randomly selected individuals. Control CCS were obtained from the MESA database (includes 6,000 < participants); arterial age was calculated from CCS. RA patients were significantly older (10.45 ± 18.45 years, < 0.001) in terms of the arterial age than the age-, gender-, and race-matched controls. The proportion of RA patients who had zero CCS was significantly less ( < 0.01) than that of those in the MESA reference group. Each disease year contributed an extra 0.395 years ( < 0.01) on the top of the normal aging process. However, the rate of the accelerated aging is not uniform, in the first years of the disease it is apparently faster. Smoking ( < 0.05), previous cardiovascular events ( < 0.05), and high blood pressure ( < 0.05) had additional significant effect on the aging process. In the follow-up study, inflammatory disease activity (CRP > 5 mg/L, < 0.05) especially in smokers and shorter than 10 years of disease duration ( = 0.05) had the largest impact. Arterial aging is faster in RA patients than in control subjects, particularly in the first 10 years of the disease. Inflammation, previous cardiovascular events, and smoking are additional contributing factors to the intensified coronary atherosclerosis progression. These data support that optimal control of inflammation is essential to attenuate the cardiovascular risk in RA.
类风湿关节炎（RA）患者的预期寿命比普通人群短，主要原因是存在心血管合并症。为了描述RA患者的动脉老化情况，对112例RA患者进行了冠状动脉钙化评分（CCS）检测；其中，随机选取54例患者进行了随访CCS检测。对照CCS数据来自MESA数据库（包括6000多名参与者）；根据CCS计算动脉年龄。与年龄、性别和种族匹配的对照组相比，RA患者的动脉年龄显著更大（10.45±18.45岁，P<0.001）。CCS为零的RA患者比例显著低于MESA参考组（P<0.01）。在正常衰老过程的基础上，每患病一年会额外增加0.395岁（P<0.01）。然而，加速衰老的速度并不均匀，在疾病的最初几年明显更快。吸烟（P<0.05）、既往心血管事件（P<0.05）和高血压（P<0.05）对衰老过程有额外的显著影响。在随访研究中，炎症性疾病活动（CRP>5mg/L，P<0.05），尤其是吸烟者和病程短于10年的患者（P=0.05）影响最大。RA患者的动脉老化比对照组更快，尤其是在疾病的前10年。炎症、既往心血管事件和吸烟是冠状动脉粥样硬化进展加剧的额外促成因素。这些数据支持，最佳控制炎症对于降低RA患者的心血管风险至关重要。
