الفهرس | Only 14 pages are availabe for public view |
Abstract Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that arises more frequently in females than males, being predominantly observed in the elderly. RA primarily affects the lining of the synovial joints and can cause progressive disability, premature death, and socioeconomic burdens. The clinical manifestations of symmetrical joint involvement include arthralgia, swelling, redness, and even limiting the range of motion. Early diagnosis is considered as the key improvement index for the most desirable outcomes (i.e., reduced joint destruction, less radiologic progression, no functional disability, and disease modifying anti-rheumatic drugs (DMARD)-free remission) as well as costeffectiveness as the first 12 weeks after early symptoms occur is regarded as the optimal therapeutic window. To date, the clear pathogenesis of RA has not been clarified. However, inflammatory cytokines genetics have been widely discussed and are accepted to play significant roles in the development of this complex disorder. Cells and cytokines implicated in RA pathogenesis are also involved in the development and progression of atherosclerosis, which is generally recognized as an inflammatory condition. The two diseases also share genetic and environmental risk factors, which suggests that patients who develop RA might also be predisposed to developing cardiovascular disease. In RA, inflammation and atherosclerosis are closely linked. Inflammation mediates its effects on atherosclerosis both through modulation of traditional risk factors and by directly affecting the vessel wall. Noninvasive techniques have been developed to detect vessel alterations associated with early preclinical atherosclerosis. Of these, assessment of the carotid intima media thickness (CIMT) is the most widely used surrogate endpoint. Measurement of the CIMT is independently associated with an increased CV risk in the general population, and hence, is also widely used as a noninvasive tool to determine the CV risk in other (high risk) patient populations, like RA, or in clinical trials to determine the success of interventions |