This K 23 Career Development Award will accomplish the double objective of training the candidate in patient-oriented research, and advancing current knowledge of the relationship between inflammation and atherosclerosis. For the career development component, the candidate will participate in the Master of Science in Clinical Investigation program, established at her institution with funding from a K30 Award from the NHLBI. This outstanding program is tailored to the candidate's needs, and will provide an in depth exposure to study design, data management and analysis, research ethics and scientific writing. The candidate will benefit from a rich environment of national experts in epidemiology, vascular imaging, cardiology, neurology, rheumatology and biostatistics . The objective of the research component is to examine to what extent atherosclerosis and cardiovascular morbidity are explained by systemic inflammation in rheumatoid arthritis (RA), accounting for the competing influence of established cardiovascular risk factors. The candidate will pursue three Specific Aims: (1) To determine the extent of atherosclerosis that is explained by cumulative systemic inflammation in RA; (2) To determine the role of inflammation in the progression of atherosclerosis in patients with RA; and (3) To determine the role of ongoing inflammatory disease activity as a risk factor for cardiac and cerebrovascular atherothrombotic events in RA.
For Specific Aim 1, 680 members of an established cohort of RA patients will undergo two non-invasive procedures to measure atherosclerosis: high resolution B-mode ultrasound of the carotid intima- media thickness (IMT) and ankle-arm systolic blood pressure index. These measures will be compared to the severity of joint damage, which reflects cumulative inflammation in RA.
For Specific Aim 2, the candidate will examine the influence of inflammation on the progression of carotid IMT over three years.
For Specific Aim 3, the candidate will assess the influence of ongoing inflammatory disease activity on the incidence of cardiac and cerebrovascular events in the RA cohort. This research is a novel approach to understanding the contribution of inflammation to atherosclerosis, and will point the way for future research into the mechanisms of atherogenesis. In addition, it will have implications for the management of patients with RA and other inflammatory diseases, by extending the current indications for anti- inflammatory therapy to the prevention of atherosclerosis. This would ultimately lengthen life expectancy and improve the quality of life of people with inflammatory diseases.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL004481-05
Application #
6948898
Study Section
Special Emphasis Panel (ZHL1-CSR-F (M1))
Program Officer
Olson, Jean
Project Start
2001-07-18
Project End
2007-12-31
Budget Start
2005-07-01
Budget End
2007-12-31
Support Year
5
Fiscal Year
2005
Total Cost
$129,255
Indirect Cost
Name
University of Texas Health Science Center San Antonio
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800772162
City
San Antonio
State
TX
Country
United States
Zip Code
78229
Restrepo, José Félix; del Rincón, Inmaculada; Battafarano, Daniel F et al. (2015) Clinical and laboratory factors associated with interstitial lung disease in rheumatoid arthritis. Clin Rheumatol 34:1529-36
del Rincón, Inmaculada; Battafarano, Daniel F; Restrepo, Jose F et al. (2014) Glucocorticoid dose thresholds associated with all-cause and cardiovascular mortality in rheumatoid arthritis. Arthritis Rheumatol 66:264-72
Evans, Matthew R; Escalante, Agustín; Battafarano, Daniel F et al. (2011) Carotid atherosclerosis predicts incident acute coronary syndromes in rheumatoid arthritis. Arthritis Rheum 63:1211-20
Roldan, Jose F; Escalante, Agustin; del Rincon, Inmaculada (2008) Impaired arterial function associated with thinning of cortical bone in rheumatoid arthritis. Arthritis Rheum 59:523-30
Del Rincon, Inmaculada; O'Leary, Daniel H; Freeman, Gregory L et al. (2007) Acceleration of atherosclerosis during the course of rheumatoid arthritis. Atherosclerosis 195:354-60
Roldan, Jose F; Del Rincon, Inmaculada; Escalante, Agustin (2006) Loss of cortical bone from the metacarpal diaphysis in patients with rheumatoid arthritis: independent effects of systemic inflammation and glucocorticoids. J Rheumatol 33:508-16
Escalante, Agustin; Haas, Roy W; del Rincon, Inmaculada (2005) Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med 165:1624-9
Escalante, Agustin; Haas, Roy W; del Rincon, Inmaculada (2005) A model of impairment and functional limitation in rheumatoid arthritis. BMC Musculoskelet Disord 6:16
del Rincon, Inmaculada; Freeman, Gregory L; Haas, Roy W et al. (2005) Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis. Arthritis Rheum 52:3413-23
del Rincon, I; Haas, R W; Pogosian, S et al. (2005) Lower limb arterial incompressibility and obstruction in rheumatoid arthritis. Ann Rheum Dis 64:425-32

Showing the most recent 10 out of 21 publications