Publication: Estudio de grosor íntima-media, factores de riesgo cardiovascular y eventos cardiovasculares en espondiloartropatías
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2018-04-04
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Universidad Complutense de Madrid
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Abstract
La recién acuñada espondiloartritis axial (EspA), que incluye a la espondilitis anquilosante (EA) es una enfermedad inflamatoria que afecta principalmente a varones jóvenes. Característicamente produce dolor y limitación funcional progresiva del esqueleto axial, además de otras manifestaciones como artritis periférica, uveítis, entesitis y manifestaciones sistémicas. Los antiinflamatorios no esteroideos (AINE) han sido durante muchos años y aún son la piedra angular del tratamiento de esta enfermedad. En los últimos años las terapias biológicas, en especial los fármacos dirigidos contra el TNF alfa, como el infliximab, han significado un cambio disruptivo en el tratamiento, especialmente para los casos moderados y graves. Estos fármacos producen una dramática disminución de la inflamación sistémica provocada por la enfermedad. La incidencia de eventos cardiovasculares está aumentada en las EspA. Las causas de este fenómeno son diversas. Los pacientes con EspA asocian comorbilidades que favorecen el desarrollo de aterosclerosis como síndrome metabólico, obesidad, hipertensión arterial (HTA) o diabetes mellitus (DM). La propia inflamación sistémica provocada por la enfermedad parece contribuir de manera muy significativa al desarrollo de aterosclerosis. El riesgo de padecer eventos cardiovasculares es consecuencia de la aterosclerosis. La aterosclerosis es el resultado de un proceso inflamatorio iniciado en los vasos sanguíneos que comprende tres fenómenos sucesivos: disfunción endotelial, rigidez arterial y aumento del grosor íntima‐media (GIM). El resultado es la formación de placas de ateroma...
Ankylosing spondylitis (AE) and the recently coined concept of axial spondyloarthropathy (AEspA) are inflammatory diseases that affect mainly young men. They produces pain and progressive mobility limitation of axial squeleton as well as peripheral articulation and systemic involvement. The non‐steroidal anti‐inflammatory drugs (NSAIDS) have been the cornerstone of the therapy for this disease for years, because they reduce the pain. However, NSAIDS increase cardiovascular risk. Infliximab (IFX) is a drug of the family of monoclonal antibody against tumoral necrosis factor alpha (TNF alpha). These therapies have changed dramatically the treatment of AEspA because of its effectivity in controlling disease activity. The cardiovascular risk is consequence of the atherosclerosis process and it causes cardiovascular events (cerebrovascular and cardiovascular disease…). Atherosclerosis is an inflammatory process that involve vascular vessels and it have four phases: endothelial dysfunction, arterial stiffness and increase intima‐media thickness (IMT) and atheroma plaque formation. The measurement by ultrasonography of IMT is an easy and economic method for the evaluation of cardiovascular risk...
Ankylosing spondylitis (AE) and the recently coined concept of axial spondyloarthropathy (AEspA) are inflammatory diseases that affect mainly young men. They produces pain and progressive mobility limitation of axial squeleton as well as peripheral articulation and systemic involvement. The non‐steroidal anti‐inflammatory drugs (NSAIDS) have been the cornerstone of the therapy for this disease for years, because they reduce the pain. However, NSAIDS increase cardiovascular risk. Infliximab (IFX) is a drug of the family of monoclonal antibody against tumoral necrosis factor alpha (TNF alpha). These therapies have changed dramatically the treatment of AEspA because of its effectivity in controlling disease activity. The cardiovascular risk is consequence of the atherosclerosis process and it causes cardiovascular events (cerebrovascular and cardiovascular disease…). Atherosclerosis is an inflammatory process that involve vascular vessels and it have four phases: endothelial dysfunction, arterial stiffness and increase intima‐media thickness (IMT) and atheroma plaque formation. The measurement by ultrasonography of IMT is an easy and economic method for the evaluation of cardiovascular risk...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 23-06-2017