Evidence of systemic inflammation and estimation of coronary artery disease risk: a population perspective
1Cardiology Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30306-2636, USA. pwwilso@emory.edu
Insights
Patients with immune-inflammatory diseases face higher cardiovascular risks not explained by traditional factors. Inflammation markers, not just traditional risks, are crucial for accurate cardiovascular disease assessment in these individuals.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Patients with immune-inflammatory diseases have increased cardiovascular morbidity and mortality.
- Traditional coronary artery disease (CAD) risk factors do not fully explain this elevated risk.
- Chronic inflammation is increasingly recognized as a key driver of atherosclerosis and CAD.
Purpose of the Study:
- To investigate the role of inflammation in cardiovascular risk in patients with immune-inflammatory diseases.
- To determine if nontraditional risk factors, like inflammation biomarkers, contribute to CAD risk in these patients.
- To highlight the need for comprehensive risk assessment beyond traditional factors.
Main Methods:
- Analysis of the Framingham patient cohort.
- Examination of associations between markers of inflammation and overall CAD risk.
- Consideration of both traditional and nontraditional CAD risk factors.
Main Results:
- Found significant associations between inflammation markers and overall CAD risk.
- Indicated that traditional risk factor evaluation may underestimate CAD risk in this population.
- Highlighted elevated levels of nontraditional CAD risk factors in patients with immune-inflammatory diseases.
Conclusions:
- Inflammatory biomarkers are important contributors to cardiovascular risk assessment.
- Comprehensive CAD risk evaluation must include inflammatory markers alongside traditional risk factors.
- Conditions like rheumatoid arthritis and systemic lupus erythematosus increase inflammation and thus cardiovascular risk.
Abstract:
A growing body of evidence indicates that patients with immune-inflammatory diseases experience an increased risk for cardiovascular morbidity and mortality. However, patients with immune-inflammatory diseases do not exhibit a corresponding increase in traditional coronary artery disease (CAD) risk factors that could explain the observed increase in CAD. Chronic inflammation is now accepted as playing a potentially important role in the promotion of atherosclerosis, a main cause of CAD. Evidence is also accumulating to suggest that the chronic systemic inflammation associated with immune-inflammatory diseases results in elevated levels of nontraditional CAD risk factors, such as biomarkers of inflammation, in patients with these conditions. Evaluation of only traditional CAD risk factors in these patients, therefore, may result in the underestimation of their future overall CAD risk. Using the Framingham patient cohort, we found associations between markers of inflammation and CAD risk overall. The contribution of inflammatory biomarkers should be considered along with the status of traditional CAD risk factors to gain a complete picture of the CAD risk in patients with underlying conditions that increase inflammation such as rheumatoid arthritis or systemic lupus erythematosus.
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