Background Cigarette smoking significantly increases the risk of cardiovascular diseases (CVD) and predisposes to rheumatoid arthritis (RA) development.
Objectives Investigate the impact of smoking on serum pro-atherogenic chemokines (CX3CL1 – fractalkine, CCL2 – monocyte chemotactic protein-1, CCL5 – RANTES) and endothelial derivatives (ICAM-1 – intercellular adhesion molecule-1, VEGF – vascular endothelial growth factor) levels in RA patients with hypercholesterolaemia treated with atorvastatin (ATS).
Methods The study included 36, mainly female (91.7%), RA patients (age – 60.1±7.6 years, anti-CCP positive – 75.0%, total cholesterol – 259±26 mg/dl). All patients received a 16 week ATS treatment, 10 mg daily, according to ATP III guidelines. The Systematic Coronary Risk Evaluation (SCORE) was assessed and serum CX3CL1, CCL2, CCL5, ICAM-1 and VEGF levels were measured using ELISA (R&D Systems) before and after the ATS treatment. Cigarette smoking was determined as being an ever-smoker (63.9%) or a never smoker (non-smoker). A statistical analysis was performed using Mann-Whitney and Wilcoxon tests (Statistica v. 10).
Results No statistically significant differences were found between smokers and non-smokers at the beginning of the observations, except for SCORE (7.13 vs. 3.92, p=0.031) and the disease duration (6.4 vs. 15.9 years, p=0.002). SCORE values, total cholesterol and ICAM-1 serum concentrations decreased during the study in both groups; in smokers: 7.13 vs. 4.44 (p=0.001), 258 vs. 197 mg/dl (p<0.001), 130 vs. 113 pg/ml (p=0.005), respectively, and in non-smokers: 3.29 vs. 3.00 (p=0.069), 261 vs. 213 mg/dl (p=0.012), 132 vs. 108 pg/ml (p=0.018), respectively. After the ATS treatment, CX3CL1 and CCL5 levels dropped significantly only in ever-smoking patients: 1779 vs. 1446 pg/ml (p=0.031) and 1348 vs. 1020 pg/ml (p=0.001), respectively. The ATS treatment had no effect on serum CCL2 and VEGF throughout the observation period.
Conclusions By lowering serum cholesterol, the atorvastatin treatment reduces the risk of CVD (SCORE) in smoking and non-smoking RA patients. Ever-smoking RA patients may benefit additionally from a routine statin use, as atorvastatin simultaneously normalizes serum levels of some pro-atherogenic chemokines and endothelial derivatives.
Disclosure of Interest None Declared
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