Why rheumatoid arthritis needs cardiologists

Traditional cardiovascular risk factors, inflammation and cardiovascular risk in rheumatoid arthritis. Rheumatology Oxford ;— Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis. Disease activity in rheumatoid arthritis and the risk of cardiovascular events. Arthritis Rheumatol ;— The role of rheumatoid arthritis RA flare and cumulative burden of RA severity in the risk of cardiovascular disease.

Ann Rheum Dis ;—5. Mortality trends in rheumatoid arthritis: the role of rheumatoid factor. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation ;— Comparison of interleukin-6, C-reactive protein, and low-density lipoprotein cholesterol as biomarkers of residual risk in contemporary practice: secondary analyses from the Cardiovascular Inflammation Reduction Trial.

Association between serum interleukin-6 concentration and mortality in patients with coronary artery disease. Mediators Inflamm ; The interleukin-6 receptor as a target for prevention of coronary heart disease: a Mendelian randomisation analysis. Lancet ;— Interleukin-6 signaling effects on ischemic stroke and other cardiovascular outcomes: a Mendelian randomization study. Circ Genom Precis Med ;e Inflammatory markers at the site of ruptured plaque in acute myocardial infarction: locally increased interleukin-6 and serum amyloid A but decreased C-reactive protein.

Interleukin-6 derived from hypoxic myocytes promotes neutrophil-mediated reperfusion injury in myocardium. J Thorac Cardiovasc Surg ;—7. NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals.

Nature ;— Interleukin-1 blockade in cardiovascular diseases: a clinical update. Eur Heart J ;—9. The NLRP3 inflammasome is up-regulated in cardiac fibroblasts and mediates myocardial ischaemia-reperfusion injury. Cardiovasc Res ;— Inflammatory cytokines and risk of coronary heart disease: new prospective study and updated meta-analysis. Ann Rheum Dis ;—6. Inflammatory mediators and premature coronary atherosclerosis in rheumatoid arthritis. Arthritis Rheum ;—5. Changes in lipid levels with inflammation and therapy in RA: a maturing paradigm.

Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. Ann Rheum Dis ;—7. Exploring the lipid paradox theory in rheumatoid arthritis: associations of low circulating low-density lipoprotein concentration with subclinical coronary atherosclerosis. Effects of disease activity on lipoprotein levels in patients with early arthritis: can oxidized LDL cholesterol explain the lipid paradox theory?

Arthritis Res Ther ;—8. Proinflammatory high-density lipoprotein as a biomarker for atherosclerosis in patients with systemic lupus erythematosus and rheumatoid arthritis. Arthritis Rheum ;—9. Association between inflammation and systolic blood pressure in RA compared to patients without RA.

Arthritis Res Ther ;—9. Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med ;—9.

Rheumatoid arthritis, insulin resistance, and diabetes. Joint Bone Spine ;—6. Misperception of the cardiovascular risk in patients with rheumatoid arthritis. Strategies for implementation of guideline recommended cardiovascular risk management for patients with rheumatoid arthritis: results from a questionnaire survey of expert rheumatology centers.

Rheumatol Int ;—7. Cardiovascular disease assessment in rheumatoid arthritis: a guide to translating knowledge of cardiovascular risk into clinical practice. Ann Rheum Dis ;—8. Performance of four current risk algorithms in predicting cardiovascular events in patients with early rheumatoid arthritis. Circulation ;e— Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis. PLoS One ;e Derivation and internal validation of an expanded cardiovascular risk prediction score for rheumatoid arthritis: a Consortium of Rheumatology Researchers of North America registry study.

Rheumatoid arthritis-specific cardiovascular risk scores are not superior to general risk scores: a validation analysis of patients from seven countries. Cardiovascular risk assessment in patients with rheumatoid arthritis using carotid ultrasound B-mode imaging.

Rheumatol Int ;— Exploring cardiovascular disease risk evaluation in patients with inflammatory joint diseases.

Int J Cardiol ;—6. A multicenter, randomized, placebo-controlled trial of atorvastatin for the primary prevention of cardiovascular events in patients with rheumatoid arthritis. Randomised trial of cholesterol lowering in patients with coronary heart disease: the Scandinavian Simvastatin Survival Study 4S. Lancet ;—9. Effect of intensive lipid-lowering therapy on cardiovascular outcome in patients with and those without inflammatory joint disease.

The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: a meta-analysis.

Clin Exp Rheumatol ;— Smoking cessation is associated with lower disease activity and predicts cardiovascular risk reduction in rheumatoid arthritis patients. The effect of brief versus individually tailored dietary advice on change in diet, lipids and blood pressure in patients with inflammatory joint disease. Food Nutr Res ; Perceived barriers, facilitators and benefits for regular physical activity and exercise in patients with rheumatoid arthritis: a review of the literature.

Sports Med ;— Effect of interleukin-6 receptor blockade on surrogates of vascular risk in rheumatoid arthritis: MEASURE, a randomised, placebo-controlled study. Response to anti-tumour necrosis factor alpha blockade is associated with reduction of carotid intima-media thickness in patients with active rheumatoid arthritis.

Rheumatology Oxford ;—5. Metabolic and cardiovascular benefits of hydroxychloroquine in patients with rheumatoid arthritis: a systematic review and meta-analysis. Ann Rheum Dis ;e Anti-tumor necrosis factor-alpha treatment improves endothelial function in patients with rheumatoid arthritis. Circulation ;—7. Methotrexate — how does it really work? Nat Rev Rheumatol ;—8. Unfortunately, primary care physicians also tend to under-recognize cardiovascular risks in patients with RA , she added.

This lack of management of cardiovascular symptoms has resulted in only one in three patients with RA receiving annual risk factor screening, according to the Comorbidities in Rheumatoid Arthritis study, Husni said.

Also, when we send patients to them, they help us understand the guidelines. Husni noted that improving cardiovascular outcomes among patients with RA will require an ability to monitor or image subclinical disease, as well as the identification of relevant biomarkers to help providers evaluate subclinical disease.

In addition, reducing cardiovascular mortality and morbidity will mean better risk stratification in systemic rheumatic diseases, as well as adequate disease control. We need to be aggressive about adequate disease control. We need to have a target, not just for joints but also cardiovascular comorbidity. Husni ME. Inflammation is the new cholesterol: Appraising the data and reducing risks of cardiovascular disease.

Healio News Rheumatology Rheumatoid Arthritis. Basic and Clinical Immunology for the Busy Clinician. Roman MJ et al. Ann Intern Med : — You can also search for this author in PubMed Google Scholar. Reprints and Permissions. Braybrook, C. Are patients with rheumatoid arthritis prone to accelerated atherosclerosis?. Nat Rev Cardiol 3, — Download citation. Issue Date : June