Augmentation index in patients with rheumatoid arthritis and ankylosing spondylitis treated with infliximab |
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Authors: | Herwig Pieringer Ulrike Stuby Erich Pohanka Georg Biesenbach |
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Institution: | (1) Section of Rheumatology, 2nd Department of Medicine, General Hospital Linz, Krankenhausstr. 9, A-4020 Linz, Austria |
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Abstract: | Premature atherosclerosis is linked to inflammation. Arterial stiffness is a marker of vascular dysfunction. We tested the
hypothesis that treatment with infliximab, which is effective in reducing inflammation in rheumatoid arthritis (RA) and ankylosing
spondylitis (AS), also lowers the augmentation index (AIx) in patients with active disease. We also analyzed the subendocardial
viability ratio (SEVR), which is a measure of myocardial perfusion relative to cardiac workload. Included in the study were
30 patients (17 RA, 13 AS). Conventional treatment failed in all patients. The AIx and SEVR were determined by radial applanation
tonometry before and after treatment with infliximab, at baseline and at week 7. After treatment with infliximab, Disease
Activity Score for 28 joints (RA patients), Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis
Functional Index (AS patients), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) improved significantly
(p < 0.001). The AIx for all patients increased from 22.0 ± 14.0% to 24.6 ± 13.0% (p = 0.03). The increase in the RA sub-group (p = 0.01) was also significant. The SEVR decreased from 148.6 ± 23.7% to 141.2 ± 23.7% (p = 0.04). Infliximab did not reduce the AIx in patients with RA and AS, although there were clinical improvements and CRP
and ESR decreased. Instead, the AIx increased. This could negatively influence cardiac workload. |
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Keywords: | |
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