Purpose: inflammation contributes to the pathogenesis of vascular damage in cardiovascular disease (CVD). Rheumatoid arthritis (RA) is associated with systemic inflammation and is considered as independent risk factor of cardiovascular events. The severity of RA can be assessed by disease activity score (DAS 28) and is correlated with the levels of most significant pro-inflammatory cytokines, such as TNF-alpha, IL-1beta, IL-6. The aims of this study were to determine the relationship between inflammatory markers (TNF-alpha, IL-1, IL-6) and the incidence of CVD clinical manifestation in RA pts.
Methods: 120 pts with determined RA were monitored during 12 months. We evaluated activity of RA by DAS 28 index, serum C-reactive protein and pro-inflammatory cytokines (TNF-alpha, IL-1-beta, IL-6). At the same time as we assessed the systemic cardiovascular risk and incidence of cardiovascular events: severe hypertensive crisis, arrhythmia, unstable angina, myocardial infarction, stroke, sudden cardiac death.
Results: In observed group the most common cardiovascular manifestations were: arterial hypertension, arrhythmias, angina pectoris, chronic heart failure. The cases of complicated hypertensive crisis, arrhythmias, unstable angina and myocardial infarction were preferably revealed in pts with high activity RA (DAS 28 >5). There was a significant correlation between the levels of TNF-alpha, IL-1beta, IL-6 and cardiovascular risk in RA pts. According the χ2 criterion the incidence of cardiovascular events was significantly more in pts with elevated cytokine level.
Conclusions: The increased serum levels of TNF-alpha, IL-1beta, IL-6 in RA may play a significant role in CVD manifestation and can be considered as predictors of cardiovascular events.