Papers by Carlos Gonzalez-juanatey
PLoS ONE, 2012
Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased ... more Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased cardiovascular (CV) mortality. Since CD40-CD154 binding has direct consequences on inflammation process initiation, we aimed to replicate previous findings related to disease susceptibility in Spanish RA population. Furthermore, as the major complication in RA disease patients is the development of CV events due to accelerated atherosclerosis, and elevated levels of CD40L/CD154 are present in patients with acute myocardial infarction, we assessed the potential association of CD40 and CD154/CD40L gene variants with CV risk in Spanish RA patients.
Arthritis Research & Therapy, 2012
ABSTRACT: INTRODUCTION: Rheumatoid arthritis (RA) is an inflammatory disease associated with acce... more ABSTRACT: INTRODUCTION: Rheumatoid arthritis (RA) is an inflammatory disease associated with accelerated atherosclerosis and high risk of cardiovascular (CV) disease. Since genome-wide association studies demonstrated association between rs599839 polymorphism and coronary artery disease, in the present study we assessed the potential association of this polymorphism with endothelial dysfunction, an early step in atherogenesis. METHODS: 128 RA patients without history of CV events were genotyped for rs599839 A/G polymorphism. Presence of endothelial dysfunction was assessed by brachial ultrasonography (brachial flow-mediated endothelium-dependent [FMD]). RESULTS: Patients carrying the allele G exhibited more severe endothelial dysfunction (FMD%: 4.61+/-3.94%) than those carrying the wild allele A (FMD%: 6.01+/-5.15%) (P=0.08). Adjustment for gender, age at the time of study, follow-up time and classic CV risk factors disclosed a significant association between the rs599839 polymorphism and FMD (G vs. A: P=0.0062). CONCLUSIONS: Our results confirm an association of the rs599839 polymorphism with endothelial dysfunction in RA.
Atherosclerosis, 2012
Rheumatoid arthritis (RA) is an inflammatory disease associated with increased cardiovascular (CV... more Rheumatoid arthritis (RA) is an inflammatory disease associated with increased cardiovascular (CV) mortality. A recent study has disclosed association between NFKB1-94ATTG ins/del polymorphism and higher risk of coronary heart disease in healthy Caucasians. Because of that, we assessed the influence of this polymorphism in the risk of CV disease in RA patients. 1437 Spanish patients with RA were genotyped for the NFKB1-94ATTG ins/del polymorphism. Two hundred and seventy-one of them (18.8%) had experienced CV events. After adjusting for sex, age at RA diagnosis and traditional CV risk factors RA patients carrying the NFKB1 del/del genotype had higher risk of CV events than those with ins/ins genotype (Hazard ratio [HR] = 1.76, 95% CI: 1.05-2.97, p = 0.03), while heterozygous patients had an intermediate (but non-significant) risk (HR = 1.31, 95% CI: 0.90-1.92, p = 0.16). Our results suggest that NFKB1-94ATTG ins/del polymorphism is associated with CV disease in patients with RA.
Medicine
Audiovestibular dysfunction has been reported in patients with connective tissue disease. Systemi... more Audiovestibular dysfunction has been reported in patients with connective tissue disease. Systemic sclerosis (SSc; scleroderma) is a rare connective tissue disease of unknown etiology. In the current study we assess whether audiovestibular involvement is present in patients with limited scleroderma (lSSc). To answer this question we studied a series of 35 consecutive patients who fulfilled well-established classification criteria for lSSc and had antibodies against the major centromere protein-B (CENP-B), and 59 matched controls. Individuals with a history of cerebrovascular complications, syphilis, Ménière and other vestibular syndromes, infections involving the inner ear, barotrauma, or in treatment with ototoxic drugs were excluded. The majority of patients with lSSc were women (94%). The mean age at time of study was 64.5 years, and the mean age at time of disease diagnosis was 56.9 years. Besides Raynaud phenomenon, most patients with lSSc had other typical features of CREST (c...
Arthritis Research & Therapy, 2010
Biomedicine & Pharmacotherapy, 2006
Epidemiological studies have disclosed an increased mortality due to cardiovascular (CV) complica... more Epidemiological studies have disclosed an increased mortality due to cardiovascular (CV) complications in patients with rheumatoid arthritis (RA). Patients with this disease have an increased risk of left ventricular diastolic dysfunction and congestive heart failure that is unrelated to the presence of traditional atherosclerosis risk factors or ischemic heart disease. Endothelial dysfunction, an early step in the atherogenesis process, is
Clinical and experimental rheumatology, Jan 25, 2015
To establish whether subclinical atherosclerosis is increased in patients with axial spondyloarth... more To establish whether subclinical atherosclerosis is increased in patients with axial spondyloarthritis (ax-SpA). A set of 149 consecutive patients with no history of cardiovascular disease that fulfilled the Assessment of SpondyloArthritis International Society classification criteria for ax-SpA was studied by carotid ultrasonography. Carotid intima-media thickness (cIMT) and plaques were assessed. A series of 181 community-based controls with no cardiovascular disease were studied for comparison. To establish whether ax-SpA might have a direct effect on the risk of carotid plaques or an indirect effect via its putative influence on hypertension, dyslipidaemia or obesity, we obtained adjusted odds ratios (OR) for each clinical factor by the development of adjusted models. cIMT was increased in patients (0.621±0.123 mm) when compared to controls (0.607±0.117 mm) but the difference was not significant (p=0.30). Nevertheless, carotid plaques were more commonly observed in patients with...
Arthritis & rheumatology (Hoboken, N.J.), Jan 27, 2015
Clinical and experimental rheumatology, Jan 11, 2015
We examined the association of TNF-related apoptosis-inducing ligand (TRAIL) concentrations with ... more We examined the association of TNF-related apoptosis-inducing ligand (TRAIL) concentrations with cardiovascular disease (CVD) in rheumatoid arthritis (RA) and, since osteoprotegerin (OPG) can act as a decoy receptor for TRAIL, whether TRAIL concentrations impact on the OPG level-atherosclerotic CVD relation that was recently documented in the present cohort. TRAIL concentrations were assessed by ELISA in 151 RA patients of which 75 (49.7%) had CVD comprising ischaemic heart disease (n=27), cerebrovascular accident (n=26), peripheral artery disease (n=9) or/and heart failure (HF) (n=27), and 62 controls. Mean RA duration was 12 years. In RA patients, C-reactive protein (CRP) levels and cholesterol-HDL cholesterol ratio related to TRAIL concentrations [partial R=-0.222 (p=0.006) and 0.174 (p=0.04), respectively]. TRAIL concentrations were smaller in RA patients compared to controls (median (interquartile range) = 80.2 (60.9-120.4) versus 130.4 (89.4-167.7) pg/ml, p<0.0001)). TRAIL ...
To examine endothelial function in rheumatoid arthritis patients and to assess whether clinical o... more To examine endothelial function in rheumatoid arthritis patients and to assess whether clinical or genetic factors affect the development of endothelial dysfunction. Fifty-five patients fulfilling the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis were recruited from Hospital Xeral-Calde, Lugo, Spain. Patients were required to have been treated for at least 5 years, including current treatment with one or more disease-modifying antirheumatic drugs. Patients with diabetes mellitus, renal insufficiency, or cardiovascular disease were excluded. Thirty-one age-, sex-, and ethnically matched controls were also studied. Endothelium-dependent (postischemia) and -independent (postnitroglycerin) vasodilatation were measured by brachial ultrasonography. Patients were genotyped for human leukocyte antigen (HLA)-DRB1. Patients had decreased endothelium-dependent vasodilatation (mean [+/- SD], 3.8% +/- 4.9%) compared with controls (8.0% +/- 4.5%; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). There were no differences in endothelium-independent vasodilatation. Clinical features were not associated with endothelial dysfunction. Endothelium-dependent vasodilatation was lower in the 30 rheumatoid arthritis patients with the HLA-DRB1*04 shared epitope alleles (2.4% +/- 4.1%) than in the remaining patients (5.5% +/- 5.3%; P = 0.01). Similar results were seen for patients with the HLA-DRB1*0404 shared epitope allele (-0.4% +/- 2.5%) compared with other patients (4.4% +/- 4.9%; P = 0.01). Patients with chronically treated rheumatoid arthritis had evidence of endothelial dysfunction, especially those with certain HLA-DRB1 genotypes. If confirmed, our results suggest that HLA-DRB1 status may be a predictor of cardiovascular risk in these patients.
Objective: To establish whether serum uric acid concentration correlates with carotid intimamedia... more Objective: To establish whether serum uric acid concentration correlates with carotid intimamedia wall thickness (IMT) in a cohort of psoriatic arthritis (PsA) patients without overt cardiovascular (CV) disease or classic CV risk factors who attended a community hospital. Methods: A series of 52 PsA patients were assessed by carotid ultrasonography. Carotid IMT and carotid plaques were measured in the right common carotid artery. A correlation between serum uric acid concentration and carotid IMT was assessed and receiver operating characteristic curves to evaluate the ability of serum uric acid to predict carotid IMT Ͼ 0.90 mm and carotid plaques were performed. Results: PsA patients with hyperuricemia (n ϭ 6 [11.5%]) had greater carotid IMT (mean Ϯ standard deviation: 0.89 Ϯ 0.20 mm) than those without hyperuricemia (n ϭ 46 [89%]; 0.67 Ϯ 0.16 mm) (P ϭ 0.01). Patients with carotid IMT Ͻ 0.60 mm had lower mean serum uric acid levels (4.7 Ϯ 1.2 mg/dL) than those with greater carotid IMT (5.3 Ϯ 1.7 mg/dL for patients with carotid IMT 0.76-0.90 mm and 6.4 Ϯ 1.3 mg/dL for those with carotid IMT Ͼ 0.90 mm; P for trend ϭ 0.02). A significant correlation between carotid IMT and serum uric acid concentration was observed (r ϭ 0.337; P ϭ 0.01). High serum uric acid levels were associated with an increased risk of having carotid IMT Ͼ 0.90 mm (Odds ratio ϭ 2.66 [95% confidence interval: 1.08-6.53], P ϭ 0.03, area under receiver operating characteristic curve: 0.80) or with the presence of carotid plaques (Odds ratio ϭ 1.85 [95%; confidence interval: 1.01-3.38], P ϭ 0.05, area under receiver operating characteristic curve: 0.72). Conclusions: In PsA patients without clinically evident CV disease there is a correlation between serum uric acid concentration and subclinical atherosclerosis.
To investigate the potential association between levels of the erythrocyte sedimentation rate (ES... more To investigate the potential association between levels of the erythrocyte sedimentation rate (ESR) and specific clinical features of giant cell arteritis (GCA), in particular, visual loss, in a series of consecutive patients diagnosed with GCA at the reference hospital for a well-defined population. The case records of all biopsy-proven GCA patients diagnosed at the Department of Medicine of Hospital Xeral-Calde (Lugo, Northwest Spain) between 1981 and 2006 were reviewed. Clinical information and laboratory data including ESR at the time of disease diagnosis were assessed. Only 10 (3.6%) of the 273 patients had ESR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;50 mm/h. Significant differences in the frequency of visual ischemic complications according to different levels of ESR were observed (P = 0.01), mainly due to an increased frequency of visual ischemic events in patients with ESR between 70 and 100/h at the time of disease diagnosis. Twenty-five (21%) of 120 individuals with ESR values ranging between 70 and 100 mm/h experienced permanent visual loss compared with only 10 (7%) of the remaining 153 patients (P = 0.0005; OR: 3.76 [95% CI: 1.73-8.19]). An ESR between 70 and 100 mm/h was the best predictor of visual ischemic complications (OR = 2.29 [95% CI: 1.16-4.55]; P = 0.03) and irreversible visual loss (OR = 3.58 [95% CI: 1.51-8.49]; P = 0.004). The results from this study show an increased risk of severe ocular complications in biopsy-proven GCA patients presenting with an ESR between 70 and 100 mm/h. Prompt initiation of corticosteroid therapy and close follow-up of these patients is recommended to minimize the risk of irreversible visual loss.
Background: Aspergillus infections of pacing systems are extremely uncommon, and most cases repor... more Background: Aspergillus infections of pacing systems are extremely uncommon, and most cases reported are characterized by an aggressive behavior that may lead to death of the patient.
Arthritis research & therapy, 2011
In this study, we aimed to determine the relationship between flow-mediated endothelium-dependent... more In this study, we aimed to determine the relationship between flow-mediated endothelium-dependent vasodilatation (FMD) and carotid artery intima-media wall thickness (IMT), two surrogate markers of atherosclerosis, in a series of Spanish patients with rheumatoid arthritis (RA) without clinically evident cardiovascular (CV) disease. One hundred eighteen patients who fulfilled the 1987 American College of Rheumatology classification criteria for RA, had no history of CV disease and had at least one year of follow-up after disease diagnosis were randomly selected. Brachial and carotid ultrasonography were performed to determine FMD and carotid IMT, respectively. Carotid IMT values were higher and FMD percentages derived by performing ultrasonography were lower in individuals with a long duration from the time of disease diagnosis. Patients with a disease duration ≤ 7 years had significantly lower carotid IMT (mean ± SD) 0.69 ± 0.17 mm than those with long disease duration (0.81 ± 0.12 ...
VASA. Zeitschrift für Gefässkrankheiten, 2014
BioMed research international, 2014
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerat... more Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF- α therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF- α monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the in...
Annals of the rheumatic diseases, 2014
Annals of the rheumatic diseases, 2014
BioMed Research International, 2015
The Canadian journal of cardiology, 2003
Controversy frequently exists about the actual frequency of Streptococcus bovis infective endocar... more Controversy frequently exists about the actual frequency of Streptococcus bovis infective endocarditis (IE), its incidence of malignancy and its outcome. Consequently, the characteristics of S bovis IE were examined in an unselected population of nondrug-addicted patients. The literature was also reviewed. Nondrug-addicted patients with S bovis IE were retrospectively reviewed. Clinically definite IE was diagnosed according to the Duke classification criteria at the single reference hospital for a defined population in northwestern Spain over a 13-year period. The clinical features, need for surgery and mortality rate of these patients were compared with those of other nondrug-addicted patients with IE examined during the same time period. Between 1987 and 1999, S bovis IE was diagnosed in 20 consecutive patients. This pathogen was responsible for 16.8% of the cases of definite IE in nondrug-addicted patients. Underlying conditions and embolic septic events were common. The aortic v...
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Papers by Carlos Gonzalez-juanatey