Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis

Abstract

In a large, international cohort of patients with RA, 30% of CVD events were attributable to RA characteristics. This finding indicates that RA characteristics play an important role in efforts to reduce CVD risk among patients with RA.

Atherosclerotic vascular disease in the autoimmune rheumatologic woman

“…The risk for MI may be greater for women with RA compared to men with RA . The Trans‐Atlantic Cardiovascular Consortium for Rheumatoid Arthritis recently reported that there were sex differences in CVD events rates in RA patients above the age of 40 years, where the cumulative incidence of CVD was higher for men compared to women, independent of risk factors . Despite these dismal reports, recent data at a single institution suggest that CV mortality, specifically from coronary artery disease, is improving and approaching rates similar to the non‐RA population …”

“…RA patients are at risk to have lower muscle mass with their low BMI, which may result from uncontrolled inflammation, in addition to limitations of physical activity . When comparing women versus men with RA, there are differences in the prevalence of risk factors, where men carry a higher burden of the traditional risk factors of HTN, smoking, and hyperlipidemia . In women, factors related to the RA itself, such as rheumatoid factor positivity or disease activity scores, appear to have a greater impact on CVD compared to men.…”

“…In women, factors related to the RA itself, such as rheumatoid factor positivity or disease activity scores, appear to have a greater impact on CVD compared to men. The consortium's conclusions regarding CV risk factors in RA were that 30% of CV events could be accounted for by RA‐specific risk characteristics …”

Rheumatic Diseases and Endothelial Function

“…В общей сложности 70% слу-чаев сердечно-сосудистых заболеваний были связаны со всеми факторами риска ССЗ, включая ревматоидный артрит. Вместе с тем у 30% пациентов развитие сердеч-но-сосудистых заболеваний связывалось с особенностя-ми клинического течения ревматоидного артрита [65]. Роль хронического воспаления в развитии и ускорении развития ранних признаков атеросклероза у взрослого населения при различных хронических воспалительных заболеваниях, в том числе при ревматоидном артрите, достаточно хорошо документирована исследованиями последних лет [66,67].…”

Urinary albumin excretion in rheumatoid arthritis is not associated with markers of vasculopathy in distal microvascular beds

“…RA is a chronic, autoimmune disease characterized by an increased cardiovascular burden by as much as 50%, compared with the general population . Apart from the definite role of classical cardiovascular risk factors, preclinical atherosclerosis and endothelial dysfunction triggered by systemic autoimmune inflammation contributes to excess cardiovascular risk in RA . It is postulated that these proatherogenic effects mediated by RA are not only limited in large conduit arteries with the formation of atheromatous plaques, but may also manifest as a state of generalized microvascular dysfunction that involves the coronary vessels .…”