Cardiovascular risk in vasculitis

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Immunology

Background:

• Systemic vasculitis encompasses a group of rare diseases characterized by inflammation of blood vessels.
• Cardiovascular disease (CVD) is a significant complication, impacting morbidity and mortality in patients with vasculitis.
• Understanding the specific CVD risks associated with different vasculitis types is essential for effective management.

Purpose of the Study:

• To review the cardiovascular disease burden in systemic vasculitis.
• To identify key risk factors, biomarkers, and therapeutic strategies for CVD in vasculitis patients.
• To provide a comprehensive overview of cardiovascular complications across various vasculitis syndromes.

Main Methods:

• Literature review of studies on cardiovascular disease in systemic vasculitis.
• Analysis of data on incidence, risk factors, and outcomes of cardiovascular events.
• Synthesis of current therapeutic recommendations for managing cardiovascular risk and disease activity.

Main Results:

• Ischemic heart disease and stroke are intrinsic to Kawasaki disease, Takayasu arteritis, Giant Cell Arteritis (GCA), and Behcet's disease.
• Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and cryoglobulinemic vasculitis show increased risk of ischemic heart disease and stroke.
• Venous thromboembolism risk is elevated in Behcet's disease, AAV, polyarteritis nodosa, and GCA, with peak risk around diagnosis.

Conclusions:

• Cardiovascular risk is substantially elevated in systemic vasculitis, driven by traditional and disease-specific factors.
• Aggressive control of vasculitis disease activity, particularly in AAV and GCA, is paramount to mitigate cardiovascular events.
• Therapeutic strategies include aspirin/statins for ischemic events and immunosuppression for venous thromboembolism in Behcet's disease.