Relative risk of cardiovascular events in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is associated with increased comorbidity and mortality resulting from cardiovascular disease. A review of past and recent studies suggests that inflammation and thrombosis may provide a link between both diseases. This association has significant clinical implications for therapy, because many of the drugs used in the symptomatic treatment of RA, such as nonsteroidal anti-inflammatory drugs and the new cyclooxygenase (COX)-2-specific inhibitors, affect mediators of both inflammation and thrombosis. Recent studies have elucidated the potential effects of COX-2-specific inhibitors on thrombogenic events and their potential impact on cardiovascular disease. Although a causal effect of these drugs to increase the risk of cardiovascular disease has not been established, further investigation is needed on the effects of COX-2-specific inhibitors on cardiovascular risk. Such data would be of particular importance in determining appropriate therapeutic approaches to the treatment of patients with RA who are also at risk for cardiovascular events.