Targeting CVD risk in chronic connective tissue disease

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Immunology

Background:

• Chronic inflammatory rheumatological conditions, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), are strongly linked to increased cardiovascular disease (CVD) burden.
• CVD is a primary cause of excess mortality in RA and SLE patients.
• Other conditions like psoriatic arthritis, ankylosing spondylitis, antiphospholipid syndrome, and systemic sclerosis also present heightened CVD risk.

Purpose of the Study:

• To elucidate the association between chronic inflammatory rheumatological conditions and cardiovascular disease.
• To highlight the specific risks and mechanisms linking autoimmune diseases to accelerated atherosclerosis and thrombotic events.
• To underscore the importance of addressing CVD in the management of rheumatological patients.

Main Methods:

• Review of existing studies on cardiovascular risk in various chronic inflammatory rheumatological conditions.
• Analysis of data linking inflammatory markers to subclinical atherosclerosis.
• Examination of the interplay between traditional risk factors, disease-specific elements, and drug effects in atherogenesis.

Main Results:

• CVD mortality increases early in RA, with elevated risks of myocardial infarction (MI) and CVD hospital admissions shortly after diagnosis.
• A direct correlation exists between subclinical carotid atherosclerosis and elevated inflammatory markers.
• SLE patients face a 2-10 fold higher risk of CVD events, with CVD being a leading cause of morbidity and mortality.
• Antiphospholipid antibodies contribute to accelerated atherosclerosis and thromboses.
• Chronic inflammation impacts lipid profiles and influences atherogenesis through a complex multifactorial process.

Conclusions:

• Chronic inflammation in rheumatological diseases is a significant driver of cardiovascular disease.
• Integrated management strategies addressing both rheumatological and cardiovascular aspects are essential for this patient population.
• Further research into the specific mechanisms and targeted interventions is warranted to mitigate CVD risk.