N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) and mortality risk in early inflammatory polyarthritis: results from the Norfolk Arthritis Registry (NOAR).

Background: We measured N-terminal pro-brain natriuretic peptide (NT-pro-BNP), a marker of cardiac dysfunction, in an inception cohort with early inflammatory polyarthritis (IP) and assessed its association with disease phenotype, cardiovascular disease (CVD), all-cause and CVD related mortality.

Methods: Subjects with early IP were recruited to the Norfolk Arthritis Register from January 2000 to December 2008 and followed up to death or until March 2010 including any data from the national death register. The associations of baseline NT-pro-BNP with IP related factors and CVD were assessed by linear regression.

Percutaneous device closure of atrial septal defect results in very early and sustained changes of right and left heart function.

Objectives: To investigate the echocardiographic effects of percutaneous closure of secundum atrial septal defect (ASD) in adults and assess which pre-closure parameters predict good response to closure.

Background: ASD is a common congenital heart disease often undiscovered until adulthood. ASD closure has been revolutionized by the use of percutaneous devices.

Seropositivity is associated with insulin resistance in patients with early inflammatory polyarthritis: results from the Norfolk Arthritis Register (NOAR): an observational study.

Introduction: Cardiovascular disease (CVD) is the leading cause of death in patients with inflammatory polyarthritis (IP), especially in seropositive disease. In established rheumatoid arthritis (RA), insulin resistance (IR) is increased and associated with CVD. We investigated factors associated with IR in an inception cohort of patients with early IP.

Cardiovascular risk factors in inflammatory arthritis.

Purpose Of Review: To assess factors that promote atherogenesis and cardiovascular disease (CVD) in rheumatoid arthritis (RA). Also, to determine how control of inflammation with conventional and biological antirheumatic drugs affects cardiovascular risk.

Recent Findings: An excess risk of CVD occurs early in the RA disease course and indeed may predate disease onset.

Reduction of long-term disability in inflammatory polyarthritis by early and persistent suppression of joint inflammation: results from the Norfolk Arthritis Register.

Objective: To test the predictive ability of remission in terms of long-term disability in patients with recent-onset inflammatory polyarthritis (IP).

Methods: Consecutive patients with early IP, recruited between 1990 and 1994 (first cohort) and 2000 and 2004 (second cohort), were included in this study. Remission was defined as the absence of clinically detectable joint inflammation on a 51-joint count.

Atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus.

Purpose Of Review: Our aim was to review recent studies that address the increased risk of atherosclerosis and coronary heart disease in patients with rheumatoid arthritis and systemic lupus erythematosus. We examine the strength of this association, how inflammation mediates this increased risk and what impact therapies may have.

Recent Findings: Atherosclerosis is more prevalent and accelerated in both conditions.

Prolonged combination anti-platelet therapy following per-cutaneous coronary intervention (PCI) is impractical in the elderly.

A prolonged course of anti-platelet therapy is increasingly recommended following per-cutaneous coronary intervention based on the evidence from several clinical trials. However, the practicality and risk of such therapy in unselected patient population is as yet unclear. This study shows that such prolonged regimes of anti-platelet therapy are not practical in the elderly sub-group of patients.