Kurmann Reto Daniel, Mankad Rekha
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Clin Cardiol. 2018 Feb;41(2):258-263. doi: 10.1002/clc.22916. Epub 2018 Feb 26.
Autoimmune rheumatologic conditions have increased cardiovascular morbidity and mortality compared to the general population. Many of these diseases occur more commonly in women, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis, and Sjogren's. Most of the literature that has identified the link between autoimmune diseases and atherosclerotic cardiovascular disease (ASCVD) has been regarding patients with RA and SLE. The reason for the increased ASCVD is related to both traditional risk factors for atherosclerosis and nontraditional risk factors such as the burden of inflammation. Presently, our ability to adequately determinecardiovascular risk in the autoimmune patient is subpar, as scoring systems fail to take into account the role of inflammation. No present guidelines exist that take into account the increased burden of cardiovascular disease in this complex patient cohort.
与普通人群相比,自身免疫性风湿性疾病增加了心血管疾病的发病率和死亡率。这些疾病中的许多在女性中更为常见,如类风湿性关节炎(RA)、系统性红斑狼疮(SLE)、系统性硬化症和干燥综合征。大多数已确定自身免疫性疾病与动脉粥样硬化性心血管疾病(ASCVD)之间联系的文献都与RA和SLE患者有关。ASCVD增加的原因既与动脉粥样硬化的传统危险因素有关,也与非传统危险因素如炎症负担有关。目前,我们充分确定自身免疫性疾病患者心血管风险的能力不足,因为评分系统未能考虑炎症的作用。目前不存在考虑到这一复杂患者群体中心血管疾病负担增加的指南。