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Clinical and epidemiologic aspects of Rheumatoid Arthritis. Special emphasis on cardiovascular outcome and risk factors

Bergström, Ulf LU (2011) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2011:42.
Abstract
Rheumatoid arthritis (RA) is a systemic disease, with an increased risk of co-morbidity from cardiovascular disease (CVD), in particular among those with severe disease. Environmental risk factors are of potential interest for both prevention and treatment of RA.

Our aim was to examine changes in the occurrence of CVD over time and, using immunohistochemistry, study markers of inflammation in vascular endothelial cells during treatment with a TNF-inhibitor. We also investigated predictors of RA.

Two community based of RA cohorts were established in 1978 and 1995 and compared to the corresponding background population regarding CVD. Patients were followed for 8 years, and fatal and non-fatal cardiovascular first events... (More)
Rheumatoid arthritis (RA) is a systemic disease, with an increased risk of co-morbidity from cardiovascular disease (CVD), in particular among those with severe disease. Environmental risk factors are of potential interest for both prevention and treatment of RA.

Our aim was to examine changes in the occurrence of CVD over time and, using immunohistochemistry, study markers of inflammation in vascular endothelial cells during treatment with a TNF-inhibitor. We also investigated predictors of RA.

Two community based of RA cohorts were established in 1978 and 1995 and compared to the corresponding background population regarding CVD. Patients were followed for 8 years, and fatal and non-fatal cardiovascular first events were identified.

To investigate markers of endothelial activation, we used fourteen patients with active RA who started anti-TNF treatment. Muscle biopsies were taken at baseline and 3 months after start of treatment.

To identify incident cases of RA for evaluation of predictors of RA, we used two large surveys, the Malmö Preventive Medicine Program and the Malmö Diet Cancer Study.

Cardiovascular morbidity and mortality in the two community based RA cohorts was increased compared to the background population. Treatment with adalimumab was associated with decreased expression of endothelial markers previously associated with severe systemic inflammation in RA.

Smoking and a low level of formal education were independent risk factors for RA. Moderate alcohol consumption was associated with a reduced risk of RA. Reduced pulmonary function was not associated with future RA, but smoking and low socioeconomic status were independent predictors of RA. (Less)
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author
supervisor
opponent
  • MD, PhD Nicola, Goodson, University of Liverpool.
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Rheumatoid arthritis, Cardiovascular disease and Risk factors
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2011:42
pages
122 pages
publisher
Unit of Rheumatology, Dept of Clinical Sciences, Malmö.
defense location
Medicinska klinikens aula, Ingång 35, Skånes Universitets sjukhus, Malmö
defense date
2011-05-19 09:00
ISSN
1652-8220
ISBN
978-91-86671-90-7
language
English
LU publication?
yes
id
bc300e77-9492-4dca-84fb-a3c25435105b (old id 1894489)
date added to LUP
2011-06-28 13:29:08
date last changed
2016-09-19 08:44:46
@phdthesis{bc300e77-9492-4dca-84fb-a3c25435105b,
  abstract     = {Rheumatoid arthritis (RA) is a systemic disease, with an increased risk of co-morbidity from cardiovascular disease (CVD), in particular among those with severe disease. Environmental risk factors are of potential interest for both prevention and treatment of RA. <br/><br>
Our aim was to examine changes in the occurrence of CVD over time and, using immunohistochemistry, study markers of inflammation in vascular endothelial cells during treatment with a TNF-inhibitor. We also investigated predictors of RA.<br/><br>
Two community based of RA cohorts were established in 1978 and 1995 and compared to the corresponding background population regarding CVD. Patients were followed for 8 years, and fatal and non-fatal cardiovascular first events were identified.<br/><br>
To investigate markers of endothelial activation, we used fourteen patients with active RA who started anti-TNF treatment. Muscle biopsies were taken at baseline and 3 months after start of treatment.<br/><br>
To identify incident cases of RA for evaluation of predictors of RA, we used two large surveys, the Malmö Preventive Medicine Program and the Malmö Diet Cancer Study. <br/><br>
Cardiovascular morbidity and mortality in the two community based RA cohorts was increased compared to the background population. Treatment with adalimumab was associated with decreased expression of endothelial markers previously associated with severe systemic inflammation in RA. <br/><br>
Smoking and a low level of formal education were independent risk factors for RA. Moderate alcohol consumption was associated with a reduced risk of RA. Reduced pulmonary function was not associated with future RA, but smoking and low socioeconomic status were independent predictors of RA.},
  author       = {Bergström, Ulf},
  isbn         = {978-91-86671-90-7},
  issn         = {1652-8220},
  keyword      = {Rheumatoid arthritis,Cardiovascular disease and Risk factors},
  language     = {eng},
  pages        = {122},
  publisher    = {Unit of Rheumatology, Dept of Clinical Sciences, Malmö.},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Clinical and epidemiologic aspects of Rheumatoid Arthritis. Special emphasis on cardiovascular outcome and risk factors},
  volume       = {2011:42},
  year         = {2011},
}