Actividad de la enfermedad y riesgo coronario en la artritis reumatoide. Evidencia de relación causal
Keywords:
artritis reumatoide, riesgo aterogenicoAbstract
La alteracion simultanea de marcadores inflamatorios y de riesgo coronario en la artritis reumatoide sustenta la hipotesis de actividad autoinmunecomo causa de riesgo coronario en esta enfermedad. Para analizar la evolucion y asociacion temporal de los marcadores de actividad de la enfermedad y riesgo coronario: factor reumatoide, proteina c reactiva, C3- C4 complemento, DAS-28, lipoproteina(a) e indices aterogenicos se realizo un estudio longitudinal-prospectivo en pacientes portadores de artritis reumatoide atendidos en el servicio de reumatologia del hospital Faustino Perez de Matanzas. Fueron determinados los marcadores antes mencionados en los momentos: inclusion (sintratamiento), primer y tercer mes luego del inicio de la terapia con farmacos antireumatoideos inductores de remision. El programa estadistico SPSS, version 18.0, fue empleado para el procesamiento de los datos. Los marcadores: DAS-28, factor reumatoide (en subgrupo seropositivo para este anticuerpo), lipoproteina(a), indice LDL/HDL colesterol e indice aterogenico disminuyeron al mes de comenzar el tratamiento [Test de Friedman p menor de 0,05; prueba T para muestras pareadas(captacion-mes/3er mes p menor de 0,05]. Las asociaciones bivariadas: factor reumatoide-proteina c reactiva; Lp(a)-proteina c reactiva y Lp(a)-C4 complemento no fueron significativas luego del tratamiento antes referido (correlacion de Paerson: p menor de 0,05). Los resultados apoyan el papel causal de la actividad inflamatoria cronica sobre la dislipoproteinemia aterogenica en la artritis reumatoide.Downloads
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