Silvio Romano1, Elisa Salustri1, Piero Ruscitti2, Francesco Carubbi2, Maria Penco1, Roberto Giacomelli3. 1. Cardiology, Department of Life, Health and Environmental Sciences|, University of L'Aquila, L'Aquila, Italy. 2. Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy. 3. Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy. roberto.giacomelli@cc.univaq.it.
Abstract
PURPOSE OF THE REVIEW: An increased prevalence of cardiovascular risk factors in rheumatoid arthritis (RA) is reported. The absolute cardiovascular risk in RA patients is higher than in the general population, and although the RA prognosis has gradually improved, premature cardiovascular (CV) mortality remains a matter of fact. The purpose of this review is to shed light on CV and metabolic involvement in RA, with the aim of defining its best management. RECENT FINDINGS: Multiple lines of evidence have revealed common mechanisms behind inflammatory and CV diseases and clarified the metabolic and CV pathways involved in RA and the effects of different pharmacological treatments. CV risk assessment should be mandatory in all RA patients, taking into account the impact of both diseases on patient's prognosis. Therefore, a multidisciplinary approach is the best management, and rheumatologists, cardiologists, and general practitioners must work together to significantly improve outcome and quality of life in RA patients. Future research could investigate the potential beneficial effects of a more aggressive pharmacological treatment of CV and metabolic risk factors.
PURPOSE OF THE REVIEW: An increased prevalence of cardiovascular risk factors in rheumatoid arthritis (RA) is reported. The absolute cardiovascular risk in RApatients is higher than in the general population, and although the RA prognosis has gradually improved, premature cardiovascular (CV) mortality remains a matter of fact. The purpose of this review is to shed light on CV and metabolic involvement in RA, with the aim of defining its best management. RECENT FINDINGS: Multiple lines of evidence have revealed common mechanisms behind inflammatory and CV diseases and clarified the metabolic and CV pathways involved in RA and the effects of different pharmacological treatments. CV risk assessment should be mandatory in all RApatients, taking into account the impact of both diseases on patient's prognosis. Therefore, a multidisciplinary approach is the best management, and rheumatologists, cardiologists, and general practitioners must work together to significantly improve outcome and quality of life in RApatients. Future research could investigate the potential beneficial effects of a more aggressive pharmacological treatment of CV and metabolic risk factors.
Authors: M J L Peters; D P M Symmons; D McCarey; B A C Dijkmans; P Nicola; T K Kvien; I B McInnes; H Haentzschel; M A Gonzalez-Gay; S Provan; A Semb; P Sidiropoulos; G Kitas; Y M Smulders; M Soubrier; Z Szekanecz; N Sattar; M T Nurmohamed Journal: Ann Rheum Dis Date: 2009-09-22 Impact factor: 19.103
Authors: Ramón Estruch; Emilio Ros; Jordi Salas-Salvadó; Maria-Isabel Covas; Dolores Corella; Fernando Arós; Enrique Gómez-Gracia; Valentina Ruiz-Gutiérrez; Miquel Fiol; José Lapetra; Rosa Maria Lamuela-Raventos; Lluís Serra-Majem; Xavier Pintó; Josep Basora; Miguel Angel Muñoz; José V Sorlí; José Alfredo Martínez; Miguel Angel Martínez-González Journal: N Engl J Med Date: 2013-02-25 Impact factor: 91.245
Authors: E E A Arts; C Popa; A A Den Broeder; A G Semb; T Toms; G D Kitas; P L van Riel; J Fransen Journal: Ann Rheum Dis Date: 2014-01-03 Impact factor: 19.103
Authors: Cynthia S Crowson; Eric L Matteson; Veronique L Roger; Terry M Therneau; Sherine E Gabriel Journal: Am J Cardiol Date: 2012-04-20 Impact factor: 2.778
Authors: Alfonso Corrales; Carlos González-Juanatey; María E Peiró; Ricardo Blanco; Javier Llorca; Miguel A González-Gay Journal: Ann Rheum Dis Date: 2013-03-16 Impact factor: 19.103
Authors: Silvia Rollefstad; Tore K Kvien; Ingar Holme; Anne S Eirheim; Terje R Pedersen; Anne Grete P Semb Journal: Ann Rheum Dis Date: 2012-12-22 Impact factor: 19.103
Authors: Katherine P Liao; Martin P Playford; Michelle Frits; Jonathan S Coblyn; Christine Iannaccone; Michael E Weinblatt; Nancy S Shadick; Nehal N Mehta Journal: J Am Heart Assoc Date: 2015-01-30 Impact factor: 5.501
Authors: Antonios Stavropoulos-Kalinoglou; Giorgos S Metsios; Jet J J C S Veldhuijzen van Zanten; Peter Nightingale; George D Kitas; Yiannis Koutedakis Journal: Ann Rheum Dis Date: 2012-11-15 Impact factor: 19.103
Authors: Marco Bernardi; Anna Lucia Fedullo; Barbara Di Giacinto; Maria Rosaria Squeo; Paola Aiello; Donatella Dante; Silvio Romano; Ludovico Magaudda; Ilaria Peluso; Maura Palmery; Antonio Spataro Journal: Oxid Med Cell Longev Date: 2019-11-18 Impact factor: 6.543
Authors: Jeffrey R Curtis; Michael Weinblatt; Kenneth Saag; Vivian P Bykerk; Daniel E Furst; Stefano Fiore; Gregory St John; Toshio Kimura; Shen Zheng; Clifton O Bingham; Grace Wright; Martin Bergman; Kamala Nola; Christina Charles-Schoeman; Nancy Shadick Journal: Arthritis Care Res (Hoboken) Date: 2021-03-13 Impact factor: 4.794