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

[familial mediterranean fever]

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 .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 (PTX 3 ) were determined . Patients were followed for cardiovascular events .Amyloidosis patients secondary to FMF showed higher levels of ADMA , CRP and PTX 3 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 .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 .