Proteína C reactiva como marcador de riesgo cardiovascular en una cohorte de pacientes con artritis reumatoide.

José Antonio de Jesús Batún Garrido, Oscar Alejandro García Padrón, Marisol Salas Magaña

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Resumen

Antecedente: La proteína C reactiva es un reactante de fase aguda, que se ha asociado con el desarrollo de ateroesclerosis y con el riesgo cardiovascular.
Objetivo: Establecer la relación entre las concentraciones de la proteína C reactiva con el riesgo cardiovascular y el tratamiento de los pacientes con artritis reumatoide.
Métodos: Se realizó un estudio en 166 pacientes con el diagnostico de artritis reumatoide según los criterios ACR/EULAR 2010. Se determinaron las concentraciones séricas de proteína C reactiva ultrasensible y se compararon con los factores de riesgo cardiovascular tradicionales y no tradicionales, y con el tratamiento empleado.
Resultados: Se encontró diferencia significativa entre concentraciones elevadas de proteína C reactiva y valores elevados de c-HDL (< 0,000), edad (0,030), presencia de diabetes mellitus (0,026), factor reumatoide positivo (0,004), triglicéridos (< 0,003), mayor actividad de la enfermedad (0,001) y presencia de síndrome metabólico (0,032). Se encontró un riesgo cardiovascular de Framinghan bajo (0,004) con menores concentraciones de proteína C reactiva y riesgo moderado (0,032) a mayores concentraciones. Se encontró un índice bajo de Castellí (0,009) y de Kannel (< 0,000) a menores valores de proteína C reactiva. Los pacientes que emplearon hidroxicloroquina y metotrexato tuvieron menores concentraciones de proteína C reactiva, ocurriendo lo contrario con el empleo de glucocorticoides.
Conclusiones: Las concentraciones elevadas de proteína C reactiva se asocian con un mayor índice aterogénico y síndrome metabólico, así mismo el empleo de hidroxicloroquina y metotrexato al controlar la actividad de la enfermedad y la inflamación disminuyen el riesgo cardiovascular.

Palabras clave

Riesgo cardiovascular; Proteína C reactiva; Artritis Reumatoide

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