الفهرس 
Rheumatoid ArthritisOnly 14 pages are availabe for public view
 |  | from | 186 |  |  |
| | | from | 186 | | |
Abstract
Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease characterized by chronic erosive arthritis that mainly involves peripheral joints with prevalence of 0.3 to 1 % worldwide.
RA affects activities of daily living, significantly decreasing the quality of life of affected patients. Comorbidity is a major issue in this disorder.
Cardiovascular disease (CV) is the most common cause of premature mortality in patients with rheumatoid arthritis (RA) Morbidity and mortality rates are higher in individuals with rheumatoid arthritis (RA) than in the general population. Significantly increased risk of nearly all forms of CVD, which is not explained by traditional cardiovascular risk factors, has been reported in many epidemiological studies worldwide. The role of RA as an independent risk factor for CVD has been increasingly recognized.
Accelerated atherosclerosis, considered as an extra-articular manifestation of RA, occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators. The mechanisms which induce synovial inflammation are similar to those in unstable atherosclerotic plaque.
Articular bone erosions are a characteristic feature of rheumatoid arthritis (RA) and destruction of articular bone is associated with significant morbidity and with a poor prognosis.
Ultrasonography (US) has become a major tool for follow-up examinations and therapy monitoring of RA disease activity.
This study was conducted on 40 patients who were diagnosed as rheumatoid arthritis. Patients were recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University hospitals.
We focused on the relationship between development of cardiovascular events and erosive articular changes in RA patients in order to detect if the presence of erosive articular changes could predict the presence of cardiovascular risk factors and or its complications.
We observed the relation between cardiovascular risk factors (age, sex, BMI, hypertension, diabetes, dyslipidemia and smoking) and atherosclerosis measured by carotid intima-media thickness (cIMT).
In our study a positive correlation was noted between cIMT and age (p value<0.001) as well as hypertension, diabetes, and dyslipidemia which was also found to cause increased cIMT, and thus increase the risk of atherosclerosis.
We examined for the presence of bone erosion by musculoskeletal ultrasound, 16 patients (40%) had erosions and 24 (60%) without erosion with no statistically significance difference between right and left sides reflecting the bilaterality of this systemic disease. We found that patients with bone erosions have higher mean cIMT (0.827 ± 0.149) compared to patients without bone erosions (0.500 ± 0.127), with statistically significant p value (<0.001).
Since the presence of bone erosions was highly associated with higher mean cIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.