Rheumatoid Arthritis: A Disease Associated with Accelerated Atherogenesis
Section snippets
Methods
In this article we have examined: (1) potential mechanisms implicated in the development of atherogenesis in RA; (2) information on carotid ultrasonography in RA, a reliable and noninvasive method to detect macrovascular disease; and (3) a potential therapeutic approach to prevent accelerated atherogenesis in RA.
A literature review was conducted using a MEDLINE database search from 1982 through 2004. Articles discussing relevant, and when available, updated information on atherosclerosis and CV
Endothelial Dysfunction: An Early Step in the Development of Atherosclerosis
The endothelium plays an important role in the regulation of vascular tone, platelet activity, and thrombosis. The properties of normal endothelium make possible that an antithrombotic and anticoagulant balance may be maintained.
Vascular endothelial injury is the primary event in atherosclerosis (10) and has been associated with endothelial dysfunction (11). This may be determined as an impaired ability of the artery to dilate in response to physical and chemical stimuli due to a reduced nitric
Discussion and Conclusions
Patients with RA have an increased prevalence of coronary heart disease and a high CV mortality rate which cannot be explained only by the presence of traditional atherosclerotic risk factors.
A chronic inflammatory response may promote the development of accelerated atherogenesis in these patients. Proinflammatory cytokines, in particular TNF-α, lead to proatherogenic changes that include endothelial dysfunction, insulin resistance, a characteristic dyslipidemia, prothrombotic effects, and
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