Cardiovascular risk and rheumatoid arthritis--the next step: differentiating true soluble biomarkers of cardiovascular risk from surrogate measures of inflammation.

In the past decade, there has been a surge of interest in the examination of cardiovascular (CV) outcomes in RA, where it is widely accepted that there is an enhanced risk of CV disease (CVD). In recent years, a number of novel soluble biomarkers of CV risk have been examined in the general population to investigate whether any value is added to the routine measurement of traditional (Framingham) CV risk factors. We briefly review these novel markers and identify those markers that appear distinct to systemic inflammation, which may then be applicable to evaluation in patients with RA. We then investigate whether any of the soluble CV biomarkers provide additional information on the risk of developing subclinical CVD or cardiac events in an individual patient with RA, or whether they may only provide a surrogate measure of the systemic inflammatory load experienced by such patients.