Background Early development of atherosclerosis (AS) with higher mortality risk is observed in patients with rheumatoid arthritis (RA). Actually, this problem hasn't been solved. That's why researches devoted to finding of relationships between RA and AS is still of current interest. In RA pannus formation accompanied by the development of new blood vessels forms main clinical manifestation. Vascular endothelial growth factor A (VEGF-A) is a heparin-binding glycoprotein, that induces the growth of blood vessels and plays a role in differentiation of endothelial cells. The expression of VEGF-A increases when plaque developes.
Objectives To determine the particular qualities of VEGF-A production in patients with RA and various atherosclerotic damage of vessels.
Methods 67 Caucasian patients with RA (age - 52 yr., [38;59], DAS28 5,25 [5,5;6,4]) were included in our study. Patients had American College of Rheumatology (ACR)-defined RA (1987 classification criteria). 45 Europeoid patients with OA (56 yr., [50;63]) were in control group. All patients gave written informed consent before enrollment. Level of VEGF-A was determined by ELISA for quantitative detection of human VEGF-A (Bender MedSystem GmbH, Austria). Range of atherosclerotic damage was assessed by ultrasonography with measurement of carotid intima-media thickness (IMT). IMT measured was compared with normal values according to the age and sex classes: younger 40 yr - 0,7 mm, 40–50 yr - 0,8 mm, elder 50 yr - 0,9 mm for men; younger 45 yr - 0,7 mm, 45–60 yr - 0,8 mm, elder 60 yr - 0,9 mm for women. Results is presented as median and 25th/75th percentiles (Me [25th percentile; 75th percentile]. Descriptive statistics, non-parametric Mann-Whitney U-test, Kruskal – Wallis test were used for analysis of the results.
Results No significant differences of IMT were found between groups with RA and OA. Abnormal IMT were observed in about half of patients (Table 1).
The highest level of VEGF-A was in OA-group with stenosing plaque (p<0,01). No significant differences were found between other OA-subgroup. In patients with RA the highest level of VEGF-A was observed in subgroup with abnormal IMT (p<0,05), but not with pluques. Generally, VEGF-A production in patients with normal IMT was higher in RA-patients, but not sugnificially.
Conclusions Regulation of VEGF-A production may play a role in earlier onset of atherosclerosis in patients with RA.
Disclosure of Interest None declared