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Atherosclerosis and connective tissue diseases.

O Meyer1

  • 1Rheumatology Department, Hôpital Bichat, Paris, France. olivier.meyer@bch.ap-hop-paris.fr

Joint Bone Spine
|January 26, 2002
PubMed
Summary

Patients with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS), and rheumatoid arthritis (RA) face significantly higher risks of premature atherosclerosis and cardiovascular events. Early intervention targeting inflammation and traditional risk factors is crucial for managing these conditions and preventing heart disease.

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Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS), and rheumatoid arthritis (RA) are associated with substantially increased mortality from premature atherosclerosis, including coronary artery disease and stroke.
  • Studies indicate elevated risks, such as a 5-fold increased risk of myocardial infarction and a 6- to 10-fold increased risk of stroke in SLE patients, and a 3.6-fold increased risk of cardiovascular deaths in RA patients.

Purpose of the Study:

  • To identify and summarize the risk factors contributing to accelerated atherosclerosis in patients with SLE, APLS, and RA.
  • To explore the pathogenic mechanisms underlying inflammation-driven atherosclerosis in these autoimmune diseases.

Main Methods:

  • Review of epidemiological studies and clinical data on cardiovascular risk in patients with SLE, APLS, and RA.

Related Experiment Videos

  • Analysis of established and disease-specific risk factors for atherosclerosis.
  • Examination of the proposed inflammatory and immunological pathways involved in atherogenesis.

    • Main Results:

    • Key risk factors include traditional ones (age, high cholesterol, hypertension, diabetes, obesity) and disease-specific factors (prolonged glucocorticoid therapy, long disease duration, postmenopausal status, heart failure).
    • Systemic lupus erythematosus (SLE) is identified as an independent risk factor for atherosclerosis.
    • Pathogenesis involves inflammatory responses, autoantibodies, immune complexes, activated T cells, and immune responses to heat shock proteins (HSPs).

    Conclusions:

    • Effective management of connective tissue diseases requires early intervention for risk factors and robust control of inflammation.
    • Proactive strategies are essential to mitigate the heightened risk of atherosclerosis and cardiovascular events in patients with SLE, APLS, and RA.