Cardiovascular Risk Assessment in Rheumatoid Arthritis: Accelerated Atherosclerosis, New Biomarkers, and the Effects of Biological Therapy.
Diana PopescuElena RezusMinerva Codruta BadescuNicoleta DimaPetronela Nicoleta Seritean IsacIoan-Teodor DragoiCiprian RezusPublished in: Life (Basel, Switzerland) (2023)
Rheumatoid arthritis (RA), one of the most common of the chronic inflammatory autoimmune diseases (CIADs), is recognized as an independent cardiovascular risk factor. Traditional risk factors such as smoking, arterial hypertension, dyslipidemia, insulin resistance, and obesity are frequently found in RA. Given the increased risk of mortality and morbidity associated with cardiovascular disease (CVD) in RA patients, screening for risk factors is important. Moreover, there is a need to identify potential predictors of subclinical atherosclerosis. Recent studies have shown that markers such as serum homocysteine, asymmetric dimethylarginine, or carotid intima-media thickness (cIMT) are correlated with cardiovascular risk. Although RA presents a cardiovascular risk comparable to that of diabetes, it is not managed as well in terms of acute cardiovascular events. The introduction of biological therapy has opened new perspectives in the understanding of this pathology, confirming the involvement and importance of the inflammatory markers, cytokines, and the immune system. In addition to effects in inducing remission and slowing disease progression, most biologics have demonstrated efficacy in reducing the risk of major cardiovascular events. Some studies have also been conducted in patients without RA, with similar results. However, early detection of atherosclerosis and the use of targeted therapies are the cornerstone for reducing cardiovascular risk in RA patients.
Keyphrases
- rheumatoid arthritis
- cardiovascular events
- cardiovascular disease
- risk factors
- disease activity
- end stage renal disease
- insulin resistance
- newly diagnosed
- type diabetes
- coronary artery disease
- ejection fraction
- risk assessment
- chronic kidney disease
- ankylosing spondylitis
- prognostic factors
- interstitial lung disease
- peritoneal dialysis
- metabolic syndrome
- adipose tissue
- body mass index
- mesenchymal stem cells
- patient reported outcomes
- high fat diet
- drug induced
- hepatitis b virus
- bone marrow
- glycemic control
- heavy metals
- arterial hypertension
- mechanical ventilation
- patient reported
- ulcerative colitis
- smoking cessation
- polycystic ovary syndrome