<\/span><\/strong><\/h4>\n<\/span><\/strong><\/p>\n<\/span><\/strong><\/p>\nConf. Dr. Ancu\u021ba Codrina<\/span><\/strong>
Universitatea de Medicin\u0103 \u0219i Farmacie “Grigore T. Popa\u201d Ia\u0219i<\/span><\/strong>
Spitalul Clinic de Recuperare, Reumatologie 2<\/span><\/strong><\/h4>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.19.18″][et_pb_column type=”4_4″ _builder_version=”3.19.18″][et_pb_text _builder_version=”3.19.18″]<\/p>\n
Repere \u00een managementul riscului cardiovascular \u00een boala psoriazic\u0103<\/span>
Autor: Ancu\u021ba\u00a0<\/span>Codrina\u00a0<\/span><\/p>\nArtropatia psoriazic\u0103 (APS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o entitate heterogen\u0103, multifa\u021betat\u0103, caracterizat\u0103 prin inflama\u021bie cronic\u0103 local\u0103 (sinovial\u0103, entezitic\u0103, cutanat\u0103) \u0219i sistemic\u0103, acompaniat\u0103 de damage tisular specific, \u00een principal leziuni distructive \u0219i proliferative articulare periferice \u0219i axiale.
\u00cen fapt, conceptul de boal\u0103 psoriazic\u0103 dep\u0103\u0219e\u0219te grani\u021bele componentei articulare \u0219i cutanate, presupun\u00e2nd manifest\u0103ri sistemice polimorfe, de la cele extra-articulare, concept-related (uveita, boala inflamatorie intestinal\u0103), la complica\u021bii \u0219i comorbidit\u0103\u021bi de tipul bolii cardio-vasculare (CV), factorilor de risc CV \u0219i sindromului metabolic, cu implica\u021bii prognostice \u0219i terapeutice.
Rata \u00eenalt\u0103 de morbiditate \u0219i mortalitate CV corelat\u0103 cu activitatea \u0219i severitatea APS, inciden\u021ba ridicat\u0103 a factorilor tradi\u021bionali (obezitate, HTA, diabet, hiperlipidemie, sindrom metabolic) \u0219i evenimentelor CV (boal\u0103 coronarian\u0103, cerebro-vascular\u0103, periferic\u0103 vascular\u0103), inclusiv a celor majore (infarct, stroke, moarte CV), al\u0103turi de riscul crescut de boal\u0103 coronarian\u0103 subclinc\u0103 (markeri surogat \u2013 indicele intima-medie carotidian, placi de aterom) sunt recunoscute deopotriv\u0103 \u00een artropatia psoriazic\u0103 \u0219i psoriazisul cutanat. Mai mult, overlap-ul dinamic \u00eentre factorii tradi\u021bionali CV, inflama\u021bia sistemic\u0103, ateroscleroza precoce accelerat\u0103 \u0219i boala reumatismal\u0103 per se respect\u0103 modelul patobiologic clasic de afectare CV \u00een patologia inflamatorie cronic\u0103 imun\u0103.
Recomand\u0103rile EULAR, European League Against Rheumatism, 2016, aduc \u00een aten\u021bie direc\u021biile principale \u00een evaluarea riscului CV \u00een suferin\u021bele reumatismale cu determinism imun, sensibiliz\u00e2nd asupra necesit\u0103\u021bii controlului optimal al bolii (diagnostic precoce, strategia \u00actreat-to-target, utilizarea dinamica a remisivelor sintetice \u0219i biologice, TNF si non-TNF) \u0219i importan\u021bei managementului non-farmacologic al factorilor de risc.
Excesul de boal\u0103 CV, strategia optim\u0103 de identificare \u0219i stratificare a riscului CV, selec\u021bia medica\u021biei raportat la cardiotoxicitate constituie coordonate esen\u021biale in managementul riscului CV \u00een boala psoriazic\u0103.<\/p>\n
Updates in the management of cardiovascular risk in psoriatic disease<\/span>
Author:\u00a0Ancu\u021ba\u00a0<\/span>Codrina<\/span><\/p>\nPsoriatic arthritis (PsA) remains a heterogeneous, multifaceted entity characterized by local (synovial, enteral, cutaneous) and systemic inflammation, accompanied by specific tissue damage, mainly destructive lesions and proliferative peripheral as well as axial lesions.
In fact, the concept of psoriatic disease extends beyond the burden of articular and skin disorder, assuming a wide spectrum of systemic features ranging from concept-related manifestation to various complications and co-morbidities such as cardiovascular disease (CV) , CV risk factors and metabolic syndrome, with prognostic and therapeutic implications.
High CV morbidity and, even, mortality rate directly linked to PsA activity and severity, high incidence of traditional factors (obesity, hypertension, diabetes, hyperlipidemia, metabolic syndrome) and CV events (coronary, cerebrovascular) including major events (infarction, stroke, CV death), along with an increased risk of subclinical coronary artery disease (surrogate markers – carotid intima-medium index, atheroma plaques) are also recognized in both PsA and psoriasis.
Moreover, the dynamic overlap between traditional CV factors, systemic inflammation, early accelerated atherosclerosis and rheumatic condition per se value the classic pathobiological model of CV damage in chronic immune inflammatory pathology.
The 2016 EULAR (European League Against Rheumatism) recommendations underline the main directions in assessing CV risk in immune-mediated rheumatic disorders, emphasizing optimal disease control (early diagnosis, treat-to-target strategy, dynamic use of synthetic and biological, TNF and non-TNF, drugs) as well as the role of non-pharmacological management of risk factors.
The burden of CV disease, optimal strategy for identifying and stratifying CV risk, selection of medication based on its cardiotoxicity potential are crucial for the management of CV risk in psoriatic disease.<\/p>\n
Scurt CV<\/span><\/p>\nConferentiar universitar<\/strong>, Disciplina Reumatologie, Recuperare, Medicina Fizica si Balneologie, Universitatea de Medicina si Farmacie \u201cGrigore T. Popa\u201d Iasi.
Medic primar reumatologie si reabilitare<\/strong>, sef clinica Reumatologie 2, Spitalul Clinic Recuperare Iasi
Coordonator Centru EUSTAR 162<\/strong>, afiliat retelei EUSTAR (European Scleroderma Trials and Research Group),
Coordonator Centru Capilaroscopie<\/strong> \u2013 Network of imaging training center 2016-2021 (EULAR)
Training in capilaroscopie<\/strong> (Paris, Franta 2004), ecografie musculoscheletala (Paris, Franta, 2004; Barcelona, Spania, 2008); osteodensitometrie DXA (Bucuresti, Romania, 2006).
Membru in societati stiintifice internationale<\/strong>: EUSTAR, IASP (International Association for the Study of Pain) si Special Interest Group Musculoskeletal Pain, SLEuro (European Lupus Society)
Domenii de interes<\/strong>: terapia biologica in patologia reumatismala imun mediata, orphan disease (Sclerodermia sistemica, miopatii inflamatorii idiopatice), sarcina si patologia reumatismala imun mediata<\/p>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”3.19.4″ background_color=”rgba(117,194,33,0.23)” background_image=”https:\/\/pdi.ro\/2019\/wp-content\/uploads\/2019\/01\/back_justflowers_overlay1.png” background_blend=”luminosity” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” bottom_divider_style=”waves2″ bottom_divider_color=”#75c221″ bottom_divider_flip=”vertical”][et_pb_row custom_padding=”61px|0px|69px|0px|false|false” _builder_version=”3.18.9″][et_pb_column type=”3_5″ _builder_version=”3.18.9″][et_pb_text _builder_version=”3.19.4″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]<\/p>\n
Contacteaz\u0103 operatorul PDI 2019<\/p>\n
[\/et_pb_text][et_pb_contact_form email=”contact@pdi.ro\/2019″ submit_button_text=”Trimite mesajul” _builder_version=”3.19.4″ title_font=”||||||||”][et_pb_contact_field field_id=”Name” field_title=”Nume” _builder_version=”3.18.9″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Adresa de e-mail” field_type=”email” _builder_version=”3.19.4″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Message” field_title=”Mesajul dvs.” field_type=”text” fullwidth_field=”on” _builder_version=”3.18.9″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][et_pb_column type=”2_5″ _builder_version=”3.18.9″][et_pb_text _builder_version=”3.19.4″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]<\/p>\n
Operatorul PDI 2019<\/p>\n
[\/et_pb_text][et_pb_text _builder_version=”3.19.4″ text_font=”||||||||”]![\"\"](\"https:\/\/pdi.ro\/2019\/wp-content\/uploads\/2019\/01\/eventer_logo_150px.png\")
<\/span><\/p>\n<\/span><\/p>\n<\/span><\/p>\nAdresa: Str. A. Panu nr. 13, Iasi<\/span>
\nTel.: 0332.40.88.00-05<\/span>
\nE-mail: inscrieri@pdi.ro\/2019<\/a>
\n<\/span>Website:\u00a0<\/span>www.eventernet.ro<\/a>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"Conf. Dr. Ancu\u021ba Codrina Universitatea de Medicin\u0103 \u0219i Farmacie “Grigore T. Popa\u201d Ia\u0219i Spitalul Clinic de Recuperare, Reumatologie 2Repere \u00een managementul riscului cardiovascular \u00een boala psoriazic\u0103 Autor: Ancu\u021ba\u00a0Codrina\u00a0 Artropatia psoriazic\u0103 (APS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o entitate heterogen\u0103, multifa\u021betat\u0103, caracterizat\u0103 prin inflama\u021bie cronic\u0103 local\u0103 (sinovial\u0103, entezitic\u0103, cutanat\u0103) \u0219i sistemic\u0103, acompaniat\u0103 de damage tisular specific, \u00een principal […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"class_list":["post-4459","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/comments?post=4459"}],"version-history":[{"count":6,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459\/revisions"}],"predecessor-version":[{"id":4535,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459\/revisions\/4535"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/media?parent=4459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
<\/span><\/strong><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.19.18″][et_pb_column type=”4_4″ _builder_version=”3.19.18″][et_pb_text _builder_version=”3.19.18″]<\/p>\n Repere \u00een managementul riscului cardiovascular \u00een boala psoriazic\u0103<\/span> Artropatia psoriazic\u0103 (APS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o entitate heterogen\u0103, multifa\u021betat\u0103, caracterizat\u0103 prin inflama\u021bie cronic\u0103 local\u0103 (sinovial\u0103, entezitic\u0103, cutanat\u0103) \u0219i sistemic\u0103, acompaniat\u0103 de damage tisular specific, \u00een principal leziuni distructive \u0219i proliferative articulare periferice \u0219i axiale. Updates in the management of cardiovascular risk in psoriatic disease<\/span> Psoriatic arthritis (PsA) remains a heterogeneous, multifaceted entity characterized by local (synovial, enteral, cutaneous) and systemic inflammation, accompanied by specific tissue damage, mainly destructive lesions and proliferative peripheral as well as axial lesions. Scurt CV<\/span><\/p>\n Conferentiar universitar<\/strong>, Disciplina Reumatologie, Recuperare, Medicina Fizica si Balneologie, Universitatea de Medicina si Farmacie \u201cGrigore T. Popa\u201d Iasi. [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”3.19.4″ background_color=”rgba(117,194,33,0.23)” background_image=”https:\/\/pdi.ro\/2019\/wp-content\/uploads\/2019\/01\/back_justflowers_overlay1.png” background_blend=”luminosity” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” bottom_divider_style=”waves2″ bottom_divider_color=”#75c221″ bottom_divider_flip=”vertical”][et_pb_row custom_padding=”61px|0px|69px|0px|false|false” _builder_version=”3.18.9″][et_pb_column type=”3_5″ _builder_version=”3.18.9″][et_pb_text _builder_version=”3.19.4″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]<\/p>\n Contacteaz\u0103 operatorul PDI 2019<\/p>\n [\/et_pb_text][et_pb_contact_form email=”contact@pdi.ro\/2019″ submit_button_text=”Trimite mesajul” _builder_version=”3.19.4″ title_font=”||||||||”][et_pb_contact_field field_id=”Name” field_title=”Nume” _builder_version=”3.18.9″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Adresa de e-mail” field_type=”email” _builder_version=”3.19.4″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Message” field_title=”Mesajul dvs.” field_type=”text” fullwidth_field=”on” _builder_version=”3.18.9″ border_radii=”on||||” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][et_pb_column type=”2_5″ _builder_version=”3.18.9″][et_pb_text _builder_version=”3.19.4″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]<\/p>\n Operatorul PDI 2019<\/p>\n [\/et_pb_text][et_pb_text _builder_version=”3.19.4″ text_font=”||||||||”] <\/span><\/p>\n <\/span><\/p>\n Adresa: Str. A. Panu nr. 13, Iasi<\/span> Conf. Dr. Ancu\u021ba Codrina Universitatea de Medicin\u0103 \u0219i Farmacie “Grigore T. Popa\u201d Ia\u0219i Spitalul Clinic de Recuperare, Reumatologie 2Repere \u00een managementul riscului cardiovascular \u00een boala psoriazic\u0103 Autor: Ancu\u021ba\u00a0Codrina\u00a0 Artropatia psoriazic\u0103 (APS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o entitate heterogen\u0103, multifa\u021betat\u0103, caracterizat\u0103 prin inflama\u021bie cronic\u0103 local\u0103 (sinovial\u0103, entezitic\u0103, cutanat\u0103) \u0219i sistemic\u0103, acompaniat\u0103 de damage tisular specific, \u00een principal […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"class_list":["post-4459","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/comments?post=4459"}],"version-history":[{"count":6,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459\/revisions"}],"predecessor-version":[{"id":4535,"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/pages\/4459\/revisions\/4535"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2019\/wp-json\/wp\/v2\/media?parent=4459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Conf. Dr. Ancu\u021ba Codrina<\/span><\/strong>
Universitatea de Medicin\u0103 \u0219i Farmacie “Grigore T. Popa\u201d Ia\u0219i<\/span><\/strong>
Spitalul Clinic de Recuperare, Reumatologie 2<\/span><\/strong><\/h4>\n
Autor: Ancu\u021ba\u00a0<\/span>Codrina\u00a0<\/span><\/p>\n
\u00cen fapt, conceptul de boal\u0103 psoriazic\u0103 dep\u0103\u0219e\u0219te grani\u021bele componentei articulare \u0219i cutanate, presupun\u00e2nd manifest\u0103ri sistemice polimorfe, de la cele extra-articulare, concept-related (uveita, boala inflamatorie intestinal\u0103), la complica\u021bii \u0219i comorbidit\u0103\u021bi de tipul bolii cardio-vasculare (CV), factorilor de risc CV \u0219i sindromului metabolic, cu implica\u021bii prognostice \u0219i terapeutice.
Rata \u00eenalt\u0103 de morbiditate \u0219i mortalitate CV corelat\u0103 cu activitatea \u0219i severitatea APS, inciden\u021ba ridicat\u0103 a factorilor tradi\u021bionali (obezitate, HTA, diabet, hiperlipidemie, sindrom metabolic) \u0219i evenimentelor CV (boal\u0103 coronarian\u0103, cerebro-vascular\u0103, periferic\u0103 vascular\u0103), inclusiv a celor majore (infarct, stroke, moarte CV), al\u0103turi de riscul crescut de boal\u0103 coronarian\u0103 subclinc\u0103 (markeri surogat \u2013 indicele intima-medie carotidian, placi de aterom) sunt recunoscute deopotriv\u0103 \u00een artropatia psoriazic\u0103 \u0219i psoriazisul cutanat. Mai mult, overlap-ul dinamic \u00eentre factorii tradi\u021bionali CV, inflama\u021bia sistemic\u0103, ateroscleroza precoce accelerat\u0103 \u0219i boala reumatismal\u0103 per se respect\u0103 modelul patobiologic clasic de afectare CV \u00een patologia inflamatorie cronic\u0103 imun\u0103.
Recomand\u0103rile EULAR, European League Against Rheumatism, 2016, aduc \u00een aten\u021bie direc\u021biile principale \u00een evaluarea riscului CV \u00een suferin\u021bele reumatismale cu determinism imun, sensibiliz\u00e2nd asupra necesit\u0103\u021bii controlului optimal al bolii (diagnostic precoce, strategia \u00actreat-to-target, utilizarea dinamica a remisivelor sintetice \u0219i biologice, TNF si non-TNF) \u0219i importan\u021bei managementului non-farmacologic al factorilor de risc.
Excesul de boal\u0103 CV, strategia optim\u0103 de identificare \u0219i stratificare a riscului CV, selec\u021bia medica\u021biei raportat la cardiotoxicitate constituie coordonate esen\u021biale in managementul riscului CV \u00een boala psoriazic\u0103.<\/p>\n
Author:\u00a0Ancu\u021ba\u00a0<\/span>Codrina<\/span><\/p>\n
In fact, the concept of psoriatic disease extends beyond the burden of articular and skin disorder, assuming a wide spectrum of systemic features ranging from concept-related manifestation to various complications and co-morbidities such as cardiovascular disease (CV) , CV risk factors and metabolic syndrome, with prognostic and therapeutic implications.
High CV morbidity and, even, mortality rate directly linked to PsA activity and severity, high incidence of traditional factors (obesity, hypertension, diabetes, hyperlipidemia, metabolic syndrome) and CV events (coronary, cerebrovascular) including major events (infarction, stroke, CV death), along with an increased risk of subclinical coronary artery disease (surrogate markers – carotid intima-medium index, atheroma plaques) are also recognized in both PsA and psoriasis.
Moreover, the dynamic overlap between traditional CV factors, systemic inflammation, early accelerated atherosclerosis and rheumatic condition per se value the classic pathobiological model of CV damage in chronic immune inflammatory pathology.
The 2016 EULAR (European League Against Rheumatism) recommendations underline the main directions in assessing CV risk in immune-mediated rheumatic disorders, emphasizing optimal disease control (early diagnosis, treat-to-target strategy, dynamic use of synthetic and biological, TNF and non-TNF, drugs) as well as the role of non-pharmacological management of risk factors.
The burden of CV disease, optimal strategy for identifying and stratifying CV risk, selection of medication based on its cardiotoxicity potential are crucial for the management of CV risk in psoriatic disease.<\/p>\n
Medic primar reumatologie si reabilitare<\/strong>, sef clinica Reumatologie 2, Spitalul Clinic Recuperare Iasi
Coordonator Centru EUSTAR 162<\/strong>, afiliat retelei EUSTAR (European Scleroderma Trials and Research Group),
Coordonator Centru Capilaroscopie<\/strong> \u2013 Network of imaging training center 2016-2021 (EULAR)
Training in capilaroscopie<\/strong> (Paris, Franta 2004), ecografie musculoscheletala (Paris, Franta, 2004; Barcelona, Spania, 2008); osteodensitometrie DXA (Bucuresti, Romania, 2006).
Membru in societati stiintifice internationale<\/strong>: EUSTAR, IASP (International Association for the Study of Pain) si Special Interest Group Musculoskeletal Pain, SLEuro (European Lupus Society)
Domenii de interes<\/strong>: terapia biologica in patologia reumatismala imun mediata, orphan disease (Sclerodermia sistemica, miopatii inflamatorii idiopatice), sarcina si patologia reumatismala imun mediata<\/p>\n<\/span><\/p>\n
\nTel.: 0332.40.88.00-05<\/span>
\nE-mail: inscrieri@pdi.ro\/2019<\/a>
\n<\/span>Website:\u00a0<\/span>www.eventernet.ro<\/a>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"