الفهرس 
Rheumatoid arthritisOnly 14 pages are availabe for public view
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Abstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune
disease that arises more frequently in females than males, being
predominantly observed in the elderly. RA primarily affects the lining
of the synovial joints and can cause progressive disability, premature
death, and socioeconomic burdens.
The clinical manifestations of symmetrical joint involvement
include arthralgia, swelling, redness, and even limiting the range of
motion. Early diagnosis is considered as the key improvement index for
the most desirable outcomes (i.e., reduced joint destruction, less
radiologic progression, no functional disability, and disease modifying
anti-rheumatic drugs (DMARD)-free remission) as well as costeffectiveness as the first 12 weeks after early symptoms occur is
regarded as the optimal therapeutic window.
To date, the clear pathogenesis of RA has not been clarified.
However, inflammatory cytokines genetics have been widely discussed
and are accepted to play significant roles in the development of this
complex disorder.
Cells and cytokines implicated in RA pathogenesis are also
involved in the development and progression of atherosclerosis, which
is generally recognized as an inflammatory condition. The two diseases
also share genetic and environmental risk factors, which suggests that
patients who develop RA might also be predisposed to developing
cardiovascular disease. In RA, inflammation and atherosclerosis are closely linked. Inflammation mediates its effects on atherosclerosis
both through modulation of traditional risk factors and by directly
affecting the vessel wall.
Noninvasive techniques have been developed to detect vessel
alterations associated with early preclinical atherosclerosis. Of these,
assessment of the carotid intima media thickness (CIMT) is the most
widely used surrogate endpoint. Measurement of the CIMT is
independently associated with an increased CV risk in the general
population, and hence, is also widely used as a noninvasive tool to
determine the CV risk in other (high risk) patient populations, like RA,
or in clinical trials to determine the success of interventions