Pieringer H, Hoppe U C
Academic Research Unit, Interne 2, Allgemeines Krankenhaus Linz, Krankenhausstr. 9, 4020 Linz, Österreich.
Z Rheumatol. 2013 May;72(4):361-9; quiz 370-1. doi: 10.1007/s00393-013-1198-6.
Rheumatoid arthritis (RA) is associated with a shortened life expectancy. Most premature deaths are caused by cardiovascular (CV) events; therefore it is of importance to consider the increased CV risk when treating RA patients. Traditional CV risk factors cannot fully explain the increased risk but the common understanding is that inflammation significantly contributes to the excess risk observed. Without the use of correction factors commonly used risk calculators underestimate the true CV risk in RA patients. Methotrexate and TNF inhibitors appear to be beneficial with regard to the CV risk. To date there are only few recommendations for interventions in the CV system of RA patients which go beyond those formulated for the general population. The present manuscript summarizes the published evidence concerning the increased CV risk in RA patients.
类风湿关节炎(RA)与预期寿命缩短有关。大多数过早死亡是由心血管(CV)事件引起的;因此,在治疗RA患者时考虑增加的CV风险很重要。传统的CV危险因素不能完全解释增加的风险,但普遍的认识是炎症显著促成了所观察到的额外风险。如果不使用校正因子,常用的风险计算器会低估RA患者的真实CV风险。甲氨蝶呤和肿瘤坏死因子抑制剂在CV风险方面似乎是有益的。迄今为止,针对RA患者CV系统干预的建议很少,超出了针对一般人群制定的建议。本手稿总结了已发表的关于RA患者CV风险增加的证据。