Impact of Rheumatoid Arthritis on Endothelial Function: A Comprehensive Meta-Analysis of Vascular Biomarkers and Therapeutic Interventions
Keywords:
Rheumatoid arthritis, endothelial dysfunction, nitric oxide, ICAM-1, VCAM-1, cardiovascular risk, biomarkers, systematic review, meta-analysisAbstract
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that not only affects the joints but also increases the risk of cardiovascular disease due to endothelial dysfunction. This systematic review and meta-analysis aim to evaluate the extent of endothelial dysfunction in RA, its association with biomarkers such as nitric oxide (NO), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1), and the impact of anti-inflammatory therapies on endothelial function. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science, and studies meeting specific inclusion criteria were included for analysis. The pooled results showed significant impairment in endothelial function in RA patients, with lower reactive hyperemia index (RHI) and laser Doppler vasoreactivity compared to healthy controls. Subgroup analysis revealed that longer disease duration was associated with greater microvascular impairment and less therapeutic reversal. Anti-inflammatory therapies, particularly anti-TNF-α agents, demonstrated improvements in endothelial function, though the effects were more modest in patients with prolonged disease. No significant publication bias was detected. This study highlights the importance of early intervention in RA to reduce endothelial dysfunction and cardiovascular risk, emphasizing the potential for therapies targeting endothelial health in RA patients. Further research is needed to explore long-term treatment effects and novel therapies for improving vascular health in RA.
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