CARDIOVASCULAR RISK IN COLLAGEN DISEASES

Iulia Elena Negru1, Ana Emanuela Botez1, Elena Rezu2,3,, Claudia Banu2, Nicoleta Dima1, Ciprian Rezu1,3
1
IIIrd Medical Clinic, Sf. Spiridon Clinical Emergency County Hospital, Iai
2 st
I Rheumatology Clinic, Clinical Rehabilitation Hospital, Iai
3
Gr. T. Popa University of Medicine and Pharmacy, Iai

Cardiovascular
diseases
P.0133

Introduction

Results

Collagen diseases have a multifactor etiology and complex pathogenesis.

Rheumatoid polyarthritis is an independent risk factor for the cardiovascular disease.
The degree of activation of the disease is directly correlated with the cardiovascular risk in
rheumatoid polyarthritis.

The electrographic evolution was slowly favorable under specific treatment, the rhythm
disorders being interpreted in the context of silent myocardial ischemia in the context of
rheumatoid polyarthritis and diabetic neuropathy.

Objectives
Eearly assessment of target organ damage shows significant benefits over morbidity and
cardiovascular mortality. Rheumatoid arthritis is associated with an increase cardiovascular
mortality and morbidity compared to the general population.
ESH/ESC considers a priority the studies to monitor improvement of the affected target organ in
regarding with an specific therapeutic regimen. The multivalent clinical approach of the patient
with collagen disease in relation with therapeutic and prognostic implications, underlines the
necessity to actively monitor this group of patients.

Amiodaron

Methods
57 old patient, diagnosed with stage IV seropositive rheumatoid polyarthritis at age 45, under
initial treatment with DMARDs and corticotherapy, interrupted due to the diagnosis of pulmonary
fibrosis, continued with biological therapy with Infliximab, interrupted following the identification
of an axillary adenopathy, (the complex investigations conducted deeming them inflammatory in
the context of the collagen disease), switched subsequently on rituximab, with therapeutic
response and the diminution of the disease activity scores, hypertensive, obese, dyslipidemic,
with chronic venous pathology, diabetic, developing paucisymptomatic tachy-bradyarrhythmic
episodes electrocardiographic investigation showing a polymorph ventricular extrasystolic
arrhythmia expressed in doublets, episodes of ventricular tachycardia.
Laboratory Analysis

Conclusions
Rheumatoid polyarthritis and cardiovascular diseases show common physiopathological
mechanisms, which accelerate the athero-formation process. Cardiovascular disorder in the
context of the pathology of the conjunctive tissue requires a double treatment: of the main
disease and of the cardiac disorder in itself, according to specific current guides.

References

HEMATOLOGY

INLFAMMATORY TESTS

BIOCHEMISTRY

WBC = 8500/mm

ESR = 4 mm/1h

Glucose = 140 mg/dl

AST = 83 UI/l

Hgb = 15,3 g/dl

CRP (quantitative) = 0,48 mg/d

Cholesterol = 211 mg/dl

ALT = 140 UI/l

Platelets = 240000/mm

Fibrinogen = 314mg/dl

LDLc = 135 mg/dl

GGT = 76 UI/l

Urine test summary: proteins 1+; glucose abs; ketones abs; urobilinogen 1+

1. Van Halm VP, et al. Ann Rheum Dis 2009;68:1395-1400

2. Van den Oever IA, et al. Ther Adv Musculoskelet Dis 2013;5(4):166-81
3. Villa-Forte A, Mandell BF, Cardiovascular disorders and rheumatic disease. Rev Esp
Cardiol. 2011;64(9):809-17
4. Brasington RD, Jr. Clinical features of rheumatoid arthritis . In Hochberg MC, Silman AJ,
Smolen SJ, et al, Rheumatology. Philadelphia, 5th ed. 2011; 829-838