Atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus

Haque, Sahena; Mirjafari, Hoda; Bruce, Ian N.

doi:10.1097/mol.0b013e328304b65f

Cited by 38 publications

(47 citation statements)

References 44 publications

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“…Long-term cardiovascular safety is of major concern in systemic inflammatory disease and patients with rheumatoid arthritis are more likely to have macrovascular complications compared to the general population [83,84].…”

Section: Expert Opinionmentioning

confidence: 99%

Targeting Interleukin-6 in Rheumatoid Arthritis

Yusof

Emery

2013

Drugs

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Section: Expert Opinionmentioning

confidence: 99%

Targeting Interleukin-6 in Rheumatoid Arthritis

Yusof

Emery

2013

Drugs

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“…Premature atherosclerosis has been observed during the course of different systemic inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus [7][8][9][10][11][12][13][14][15][16][17][18]. In these diseases, an increased prevalence of atherosclerosis and, consequently, increased cardiovascular morbidity and mortality has been observed.…”

Section: Introductionmentioning

confidence: 99%

Translational Mini-Review Series on Immunology of Vascular Disease: Accelerated atherosclerosis in vasculitis

Tervaert

2009

Clinical and Experimental Immunology

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SummaryPremature atherosclerosis has been observed during the course of different systemic inflammatory diseases such as rheumatoid arthritis and sytemic lupus erythematosus. Remarkably, relatively few studies have been published on the occurrence of accelerated atherosclerosis in patients with vasculitis. In giant cell arteritis (GCA), mortality because of ischaemic heart disease is not increased. In addition, intima media thickness (IMT) is lower in patients with GCA than in age-matched controls. In contrast, IMT is increased significantly in Takayasu arteritis, another form of large vessel vasculitis occurring in younger patients. In Takayasu arteritis and in Kawasaki disease, a form of medium-sized vessel vasculitis, accelerated atherosclerosis has been well documented. In small vessel vasculitis because of anti-neutrophil cytoplasmic autoantibodies-associated vasculitis, cardiovascular diseases are a major cause of mortality. IMT measurements reveal conflicting results. During active disease these patients experience acceleration of the atherosclerotic process. However, when inflammation is controlled, these patients have atherosclerotic development as in healthy subjects. Several risk factors, such as diabetes and hypertension, are present more often in patients with vasculitis compared with healthy controls. In addition, steroids may be pro-atherogenic. Most importantly, many patients have impaired renal function, persistent proteinuria and increased levels of C-reactive protein, well-known risk factors for acceleration of atherosclerosis. Enhanced oxidation processes, persistently activated T cells and reduced numbers of regulatory T cells are among the many pathophysiological factors that play a role during acceleration of atherogenesis. Finally, autoantibodies that may be relevant for acceleration of atherosclerosis are found frequently in elevated titres in patients with vasculitis. Because patients have an increased risk for cardiovascular events, vasculitis should be treated with as much care as possible. In addition, treatment should be considered with angiotensin-converting-enzyme inhibitors and/or angiotensin receptor-1 blockers, statins and acetylsalicyl acid. Finally, classical risk factors for cardiovascular disease should be monitored and treated as much as possible.

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“…A artrite reumatóide (AR) é uma doença inflamatória crônica que acomete de 0,2% a 2,0% da população brasileira [1][2][3] , preferencialmente mulheres, com pico de incidência entre os 30 e 50 anos 4 . Nos últimos anos, diferentes estudos têm demonstrado que pacientes com AR apresentam de 5 a 10 anos a menos de expectativa de vida em relação à população em geral.…”

Section: Introductionunclassified

“…Nos últimos anos, diferentes estudos têm demonstrado que pacientes com AR apresentam de 5 a 10 anos a menos de expectativa de vida em relação à população em geral. Essa diminuição está relacionada ao maior risco de doenças cardiovasculares, que é de 2 a 5 vezes maior que na população em geral 2,3,5,6 . Dessa forma, o risco cardiovascular absoluto em portadores de AR é equivalente ao dos indivíduos sem AR que são 5 a 10 anos mais velhos [6][7][8] .…”

Section: Introductionunclassified

“…Dessa forma, o risco cardiovascular absoluto em portadores de AR é equivalente ao dos indivíduos sem AR que são 5 a 10 anos mais velhos [6][7][8] . Embora o aumento do risco relativo (RR) de eventos cardiovasculares seja mais pronunciado em pacientes mais jovens, são os pacientes mais velhos portadores de AR que sofrem, em termos absolutos, um número maior de eventos, principalmente devido ao desenvolvimento de doença arterial coronária (DAC) precoce 2 . Coorte prospectiva realizada no EUA em 609 pacientes com AR durante um seguimento médio de 14 anos demonstrou risco maior de morte em indivíduos com AR em comparação à pacientes sem AR da mesma idade e sexo (Figura 1), com maior propensão à ocorrência de eventos cardiovasculares (RR = 1,6; p < 0,001) 8 .…”

Section: Introductionunclassified

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