Endothelial function in patients with familial Mediterranean fever-related amyloidosis and association with cardiovascular events.

Abstract

OBJECTIVES:

Secondary amyloidosis is the most important complication of FMF and endothelial function is more severely impaired. Elevated asymmetric dimethyl arginine (ADMA) may mediate the excess cardiovascular disease (CVD) risk of this group. We aimed to compare endothelial function characteristics, including ADMA, in patients with FMF-related amyloidosis and primary glomerulopathies and to define risk factors for a CVD event.

METHODS:

We undertook a cross-sectional study with prospective follow-up including consecutive patients with FMF-related amyloidosis (n = 98) or other non-diabetic glomerulopathies (n = 102). All patients had nephrotic-range proteinuria and normal glomerular filtration rate. Flow-mediated dilatation (FMD) was assessed and ADMA levels, CRP and pentraxin 3 (PTX3) were determined. Patients were followed for cardiovascular events.

RESULTS:

Amyloidosis patients secondary to FMF showed higher levels of ADMA, CRP and PTX3 and lower FMD as compared with patients with other glomerulopathies. Cardiovascular events (n = 54) were registered during 3 years of follow-up. Increased ADMA levels and lower FMD were observed in patients with cardiovascular risk in both groups, but especially in individuals with amyloidosis.

CONCLUSION:

Patients with FMF-related amyloidosis have increased CVD event risk, probably related to the high ADMA levels, elevated inflammatory markers and decreased FMD measures observed in these patients.

• Authors: Mahmut I Yilmaz, Erkan Demirkaya, Cengizhan Acikel, Mehmet Saldir, Servet Akar, Tuncer Cayci, Mutlu Saglam, Hilmi U Unal, Mahmut Gok, Adem Polat, Hakkı Cetinkaya, Tayfun Eyileten, Sebahattin Sari, Ali O Yildirim, Alper Sonmez, Yusuf Oguz, Abdulgaffar Vural, Seza Ozen, Juan Jesús Carrero
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 53 Issue 11 Pg. 2002-8 (Nov 2014) ISSN: 1462-0332 [Electronic] England
• PMID: 24907154 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: [email protected].

Topics

• Adolescent
• Adult
• Amyloidosis (complications, physiopathology)
• Blood Pressure (physiology)
• Cardiovascular Diseases (epidemiology, etiology, physiopathology)
• Cross-Sectional Studies
• Endothelium, Vascular (physiopathology)
• Familial Mediterranean Fever (complications, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Risk Factors
• Turkey (epidemiology)
• Vasodilation (physiology)
• Young Adult