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Mediators of Inflammation
Volume 2018, Article ID 6548715, 8 pages
Research Article

Prevalence and Determinants of Peripheral Microvascular Endothelial Dysfunction in Rheumatoid Arthritis Patients: A Multicenter Cross-Sectional Study

1UOC di Reumatologia, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
2UOC di Reumatologia, Policlinico Universitario di Monserrato, Cagliari, Italy
3UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli-Catholic University of the Sacred Heart, Roma, Italy
4Department of Clinical Pharmacology, Flinders University and Flinders Medical Centre, Adelaide, Australia
5UO di Cardiologia, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
6Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy

Correspondence should be addressed to Gian Luca Erre; ti.orebil@aculnaig.e

Received 26 July 2017; Revised 27 October 2017; Accepted 12 November 2017; Published 1 February 2018

Academic Editor: Shin-ichi Yokota

Copyright © 2018 Gian Luca Erre et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To define the prevalence and determinants of peripheral microvascular endothelial dysfunction (ED) in a large series of rheumatoid arthritis (RA) patients free of previous cardiovascular events. Materials and Methods. Data from 874 RA patients enrolled in the EDRA study (Endothelial Dysfunction Evaluation for Coronary Heart Disease Risk Estimation in Rheumatoid Arthritis— NCT02341066) were analyzed. Log-transformed reactive hyperemia index (Ln-RHI) was evaluated by peripheral arterial tonometry (PAT) using the EndoPAT2000 device: values of Ln-RHI < 0.51 were considered indicative of peripheral ED. Results. Peripheral microvascular ED was documented in one-third of RA patients (33.5%); in multiple logistic regression analysis, ACPA negativity and higher triglycerides concentrations were independently associated with the presence of peripheral ED [OR (95% CI) = 1.708 (1.218–2.396), and OR (95% CI) = 1.005 (1.002–1.009), , respectively]. Multiple regression analysis showed a positive correlation between Ln-RHI values and systolic blood pressure and HDL cholesterol levels; furthermore, higher values of Ln-RHI were associated with ACPA positivity, while smoking habit was associated with lower Ln-RHI values. Conclusions. This study demonstrates for the first time a high prevalence of peripheral microvascular ED in patients with RA free of previous cardiovascular events that appear to be only partially driven by traditional cardiovascular risk factors. The association between ACPA negativity and ED warrants further exploration.