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[Cardiovascular diseases in patients with rheumatoid arthritis during long-term methotrexate therapy].

https://arctichealth.org/en/permalink/ahliterature104112
Source
Ter Arkh. 2014;86(5):26-31
Publication Type
Article
Date
2014
Author
E V Gerasimova
T V Popkova
D S Novikova
E L Nasonov
Source
Ter Arkh. 2014;86(5):26-31
Date
2014
Language
Russian
Publication Type
Article
Keywords
Adult
Age Factors
Antirheumatic Agents - administration & dosage - adverse effects
Arthritis, Rheumatoid - blood - complications - drug therapy - epidemiology - physiopathology
Cardiovascular Diseases - blood - diagnosis - epidemiology - etiology - physiopathology
Carotid Intima-Media Thickness
Dose-Response Relationship, Drug
Female
Humans
Incidence
Lipoproteins, HDL - blood
Male
Methotrexate - administration & dosage - adverse effects
Middle Aged
Patient Acuity
Prevalence
Rheumatoid Factor - blood
Risk factors
Russia - epidemiology
Sex Factors
Time
Abstract
To compare the prevalence of risk factors, clinical and subclinical manifestations of cardiovascular diseases (CVD) and their complications in methotrexate (MT)-treated and untreated patients with rheumatoid arthritis.
The investigation enrolled 193 patients (168 women and 25 men) less than 60 years of age (mean age 49 [44; 53] years) with RA. The patients were divided into 2 groups: 1) 69 patients who received MT in a dose of 15.1 [10.2; 21] mg/week for at least 12 months (mean disease duration 25 [18; 48] months); 2) 124 patients who did not take MT. The patient groups were matched for age, gender, disease duration, RA activity, and the rate of rheumatoid factor (RF) seropositivity and extraarticular manifestations.
Dyslipidemia was significantly less frequently identified in MT-treated patients (35/69 or 51%) than in MT-untreated ones (85/124 or 69%; p = 0.01). The serum from the patients treated with MT exhibited higher high-density lipoprotein cholesterol concentrations ((1.8 [0.9; 2.0] mmol/l) than in those untreated with MT (1.2 [1.0; 1.6] mmol/l; p = 0,047). In Group 1, hypertension (49%) and diabetes mellitus (3%) were slightly rare than in Group 2 (62 and 13%, respectively; p > 0.05). Carotid atherosclerotic plaques were found in 19 and 16% and intima-media thickness (IMT) enlargement was seen in 53 and 56% of the patients in Groups 1 and 2, respectively. Silent myocardial ischemia was diagnosed in every 10 patients; heart disease (exertional angina, myocardial infarction) was in every 5 patients in both groups. Aortocoronary bypass surgery was performed in 2 (3%) patients from those who received MT and had experienced MI and in one (1.6%) patient from the MT-untreated group.
Long-term MT therapy was associated with the lower rate of dyslipidemia, but it failed to affect the incidence of CVD in patients with RA.
PubMed ID
25026799 View in PubMed
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