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Cardiovascular risk in patients with rheumatoid arthritis

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Abstract

Substantial epidemiologic data have shown an increased risk of cardiovascular (CV) disease in rheumatoid arthritis (RA) patients. Traditional CV risk factors may partly contribute to CV disease in RA; however, current evidence underlines the important role of inflammation in the pathogenesis of atherosclerosis and amplification of CV risk. Interplays between inflammation and lipid metabolism in the development of atherosclerosis have been established by recent scientific advances. Atherosclerosis is currently viewed as an inflammatory disease, and modifications of lipoproteins during inflammation accelerate atherogenesis. The role of inflammation in the increased CV risk in RA has been further demonstrated by the CV protective effect of methotrexate and TNF antagonists, particularly in patients responding to these treatments. The management of CV risk in RA should include the use of effective disease-modifying anti-rheumatic drugs to control disease activity and the treatment of traditional CV risk factors.

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  1. Division of Rheumatology, University Hospitals of Geneva, 26 Avenue Beau-Séjour, 1206, Geneva, Switzerland

    Kim Lauper & Cem Gabay

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  1. Kim Lauper
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  2. Cem Gabay
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Correspondence to Cem Gabay.

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CG has received research grants from Roche, Pfizer, and AB2 Bio and fees as speaker or consultant from Roche, Pfizer, MSD, BMS, AbbVie, Novartis, Celgene, Sanofi, Regeneron, and AB2 Bio.

KL has nothing to disclose.

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This article is a contribution to the special issue on Immunopathology of Rheumatoid Arthritis -- Guest Editors: Cem Gabay and Paul Hasler

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Lauper, K., Gabay, C. Cardiovascular risk in patients with rheumatoid arthritis. Semin Immunopathol 39, 447–459 (2017). https://doi.org/10.1007/s00281-017-0632-2

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