INFLUENCE OF THE IMMUNE STATUS AND LIPID FACTORS ON SUBCLINICAL ATHEROSCLEROSIS PROGRESSION AND DEVELOPMENT OF THE CARDIOVASCULAR DISEASES IN PATIENTS WITH RHEUMATOID ARTHRITIS

Kovalenko V.M.¹, Khimion L. , Lysenko G.I.², Garmish O.O. ³

• ¹ГУ «ННЦ «Институт кардиологии им. Н.Д. Стражеско» НАМН Украины», Киев
• ²Інститут сімейної медицини Національної медичної академії післядипломної освіти ім. П.Л. Шупика МОЗ України
• ³ГУ «ННЦ Институт кардиологии им. Н.Д. Стражеско» НАМН Украины», Киев

Summary. Summary. Objective. To investigate the influence of immune and lipid factors, use of different disease modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs) on the progression of subclinical atherosclerosis in patients with rheumatoid arthritis (RA) and their link to the development of cardio-vascular diseases in these patients.
Methods. The prevalence of traditional risk factors for the cardio-vascular diseases development; influence of the immune, cytokine, lipid factors, use of different DMARDs and NSAIDs at the progression of subclini-cal atherosclerosis and development of cardio-vas-cular diseases has been investigated in ISO RA patients
Results. It is shown that progression of subclini-cal atherosclerosis in RA patients has a different rate which depends on use an effectiveness of the DMARD and anti-inflammatory therapy, severity of the immunologic changes, activity of the immu-no-inflammatory process, endothelium activation and presence of the systemic signs.
Conclusion. In RA patients, premature accelerated atherosclerosis is a component of the systemic disease, more prevalent in non-responders to standard treatment with significant immunodeficiency which leads to the long term increase of circulating anticyclic citrulinated protein antibodies (antiCCPat), persistent high level of the systemic immuno-inflammatoryprocess, activation of en-dothelium and acceleration of atherogenesis, despite lower level of total cholesterol and low density lipoproteins (LDL). Accelerated atherosclerosis increases the risk of cardio-vascular diseases in RA.