Increased cardiovascular risk in patients with rheumatoid arthritis: an overview

Puttevils, D; Vusser, Philip De; Geusens, Piet; Dens, Jo

doi:10.1080/ac.69.2.3017291

Cited by 30 publications

(21 citation statements)

References 80 publications

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“…The high mortality rates in RA are attributed to comorbidities, particularly cardiovascular diseases, increased incidence of infections, the development of various malignancies, smoking and the drugs used in the treatment . An increased prevalence of cardiovascular diseases such as myocardial infarction and stroke has been determined in RA . Cardiovascular diseases have been the most investigated elements in terms of risk factors associated with comorbid diseases in RA.…”

Section: Introductionmentioning

confidence: 99%

Comorbidities in patients with psoriatic arthritis: a comparison with rheumatoid arthritis and psoriasis

Nas

Karkucak

Durmuş³

et al. 2015

Int J of Rheum Dis

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Section: Introductionmentioning

confidence: 99%

Comorbidities in patients with psoriatic arthritis: a comparison with rheumatoid arthritis and psoriasis

Nas

Karkucak

Durmuş³

et al. 2015

Int J of Rheum Dis

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“…This results from alterations in the structural proteins, collagen and elastin, leading to accelerated atherosclerosis, usually detected by the measurement of carotid intima-media thickness. [12][13][14][15] One meta-analysis of observational studies undertaken by a Canadian group concluded that the CVD mortality rate was increased by approximately 50% in RA patients compared with the general population, 16 with neoplastic disease and respiratory disease, particularly pneumonia, being other significant contributors. 4 Notwithstanding traditional risk factors for CVD common among RA patients in developed countries (smoking, obesity, type 2 diabetes mellitus, dyslipidaemia and others), those specifically associated with RA include the presence of extraarticular manifestations and erosions, as well as prolonged disease duration with accompanying systemic inflammation and endothelial dysfunction.…”

Section: Overall Mortality In Rheumatoid Arthritis (Ra)mentioning

confidence: 99%

Rheumatoid arthritis and risk of cardiovascular disease

Meyer¹,

Anderson²,

Ker³

et al. 2018

CVJA

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In developing countries, rheumatoid arthritis (RA) remains a seriously under-prioritised disease, particularly among the underprivileged, often resulting in presentation of patients late in the course of their disease, further complicated by limited therapeutic options and inconsistent follow up. The consequences are often severe with irreversible disability, increased frequency of co-morbidities, especially cardiovascular disease (CVD), and higher mortality rates, relative to developed countries. Despite addressing traditional cardiovascular risk factors, the impact of subclinical or 'residual' inflammation from uncontrolled RA needs to be considered. This narrative review explores the prevalence and pathogenesis of CVD in RA, including the impact of tobacco use. It discusses pitfalls in the risk assessment of CVD in patients with RA, and the effect of disease-modifying anti-rheumatic therapy on cardiovascular co-morbidity.

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“…The excess cardiovascular risk in rheumatoid arthritis (RA) patients is an important cause of morbidity and mortality (1). This added risk is brought on by the complex mechanisms of RA, which complement the action of traditional cardiovascular risk factors (2). Although RA has been well described as an independent cardiovascular risk factor (3), societal guidelines differ regarding the approach to cardiovascular primary prevention in RA patients.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular risk assessment in rheumatoid arthritis with nodulosis: approach to primary prevention

Balanescu¹,

Iosif²,

Bălănescu³

et al. 2019

Ro J Rheumatol.

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Cardiovascular risk assessment in patients with rheumatoid arthritis (RA) is challenging. Not all risk calculators adjust for RA status, yielding discording results. A 56-year-old woman with RA presented for bilateral pain and swelling in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. She was diagnosed with RA 10 years ago, currently treated with methotrexate (MTX), sulfasalazine, and hydroxychloroquine. She has a history of type 2 diabetes mellitus, a total abdominal hysterectomy with bilateral salpingo-oophorectomy for an epidermoid carcinoma of the cervix, and surgical excision of a pulmonary rheumatoid nodule. Multiple subcutaneous nodules are seen bilaterally on the MCP and PIP joints. MTX may be associated with nodulosis in RA patients, which in turn is related to a further increase in cardiovascular risk compared to RA alone. MTX was discontinued. Abatacept was the biologic of choice, due to recent evidence suggesting superior efficacy in decreasing cardiovascular risk compared to anti-TNF therapies, especially in patients with diabetes and with positive rheumatoid factor. Initiating high-dose statin and abatacept may be a useful primary prevention strategy in complex RA patients that require biologic therapy..

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Increased cardiovascular risk in patients with rheumatoid arthritis: an overview

Cited by 30 publications

References 80 publications

Comorbidities in patients with psoriatic arthritis: a comparison with rheumatoid arthritis and psoriasis

Comorbidities in patients with psoriatic arthritis: a comparison with rheumatoid arthritis and psoriasis

Rheumatoid arthritis and risk of cardiovascular disease

Cardiovascular risk assessment in rheumatoid arthritis with nodulosis: approach to primary prevention

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