Novel risk factors for cardiovascular disease in rheumatoid arthritis

Abstract

Since cardiovascular disease (CVD) is the most common cause of mortality in patients with rheumatoid arthritis (RA), we aimed to determine factors associated with such a complication in a large series of Colombian patients. This was a cross-sectional analytical study in which 800 consecutive Colombian patients with RA were assessed for variables associated with CVD. Furthermore, a systematic literature review was performed to address the state of the art about non-traditional risk factors for CVD in RA. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed in data extraction, analysis, and reporting of articles selected. Hypercholesterolemia, type 2 diabetes mellitus, abnormal body mass index, abdominal obesity, and current smoking were all traditional risk factors significantly associated with CVD in Colombians. As non-traditional risk factors, familial autoimmunity, more than 10 years of duration of the disease, patients working on household duties, use of systemic steroids, and low education level were associated with CVD in the studied population. Out of a total of 9,812 articles identified in PubMed and Scopus databases, 140 fulfilled the eligibility criteria and were included. Through this systematic review, several factors and outcomes related to CVD were confirmed and identified. These were categorized into genetics, RA-related, and others. Traditional risk factors do not completely explain the high rates of CVD in patients with RA; thus, novel risk factors related to autoimmunity are now recognized predicting the presence of CVD as strong as traditional risk factors. Our results may assist health professionals and policymakers in making decisions about CVD in patients with RA.

Hydrocortisone directly promotes cholesterol accumulation in macrophages

“…Indeed, such treatment is an independent cardiovascular risk factor in patients with systemic lupus erythematosus8 and rheumatoid arthritis 9. Our observations might encourage pursuing the recent indication that remission induction in autoimmune diseases can be obtained without the use of steroids,10 and could pave the way to new strategies to counteract steroid-induced cardiovascular damage.…”

Cardiovascular Involvement in Autoimmune Diseases

“…Likewise, the two blinded reviewers (JAA, LMS) looked for duplicates, excluded them, and organized selected articles. Only novel and classic risk factors [14, 15] with statistical significance were included.…”

“…Several novel risk factors contribute to the development of premature vascular damage. Sarmiento-Monroy et al [13], based on a model of rheumatoid arthritis (RA), proposed a classification for nontraditional risk factors in ADs, which divided them into genetic determinants, AD-related, and miscellaneous [14, 15]. Therefore, a complex interaction between traditional and disease-specific traits leads to a premature AT process in autoimmunity.…”

Ab0343 antirheumatic Therapy Is Not Associated With Changes in Circulating N-Terminal Pro-Brain Natriuretic Peptide (Nt-Probnp) Levels in Patients With Rheumatoid Arthritis

“…Traditional and "non-traditional" (e.g. RA-associated factors) were analyzed [1]. Carotid atherosclerotic plaques had been found by ultrasonography.…”