Cardiovascular disease in inflammatory rheumatic diseases

Area of Science:

• Rheumatology and Cardiology
• Immunology and Cardiovascular Health

Background:

• Chronic inflammatory rheumatic diseases (IRD) like rheumatoid arthritis increase cardiovascular (CV) morbidity and mortality.
• These conditions pose a significant global health burden, impacting healthcare systems worldwide.
• Understanding the link between chronic inflammation, atherosclerosis, and CV disease is crucial.

Purpose of the Study:

• To review the epidemiology of IRD and their associated cardiovascular risks.
• To explore traditional CV risk factors, genetics, and the inflammatory pathways linking IRD to atherosclerosis.
• To discuss management strategies for CV risk in IRD patients.

Main Methods:

• Literature review focusing on epidemiology, CV risk factors, genetics, and inflammation in IRD.
• Analysis of the relationship between active disease, plaque vulnerability, and thrombosis.
• Evaluation of current CV risk stratification and management guidelines for IRD.

Main Results:

• Patients with IRD exhibit increased vulnerability to atheromatous plaques, with higher risk of unstable plaques in rheumatoid arthritis.
• Active disease is linked to plaque vulnerability, rupture, and thrombosis in IRD patients.
• Optimal control of disease activity and CV risk stratification are essential for management.

Conclusions:

• Managing cardiovascular risk in IRD requires optimal control of disease activity and appropriate risk stratification.
• Imaging techniques may aid in assessing actual CV risk for intermediate-risk IRD patients.
• Integrated management strategies are needed to address the heightened CV burden in IRD.