Cardiology, Department of Life, Health and Environmental Sciences|, University of L'Aquila, L'Aquila, Italy.
Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy.
Curr Rheumatol Rep. 2018 Nov 5;20(12):81. doi: 10.1007/s11926-018-0790-9.
An increased prevalence of cardiovascular risk factors in rheumatoid arthritis (RA) is reported. The absolute cardiovascular risk in RA patients is higher than in the general population, and although the RA prognosis has gradually improved, premature cardiovascular (CV) mortality remains a matter of fact. The purpose of this review is to shed light on CV and metabolic involvement in RA, with the aim of defining its best management.
Multiple lines of evidence have revealed common mechanisms behind inflammatory and CV diseases and clarified the metabolic and CV pathways involved in RA and the effects of different pharmacological treatments. CV risk assessment should be mandatory in all RA patients, taking into account the impact of both diseases on patient's prognosis. Therefore, a multidisciplinary approach is the best management, and rheumatologists, cardiologists, and general practitioners must work together to significantly improve outcome and quality of life in RA patients. Future research could investigate the potential beneficial effects of a more aggressive pharmacological treatment of CV and metabolic risk factors.
据报道,类风湿关节炎(RA)患者的心血管危险因素患病率增加。RA 患者的心血管绝对风险高于普通人群,尽管 RA 的预后逐渐改善,但过早的心血管(CV)死亡率仍然是一个事实。本综述的目的是阐明 RA 中的心血管和代谢相关性,旨在确定其最佳管理方法。
越来越多的证据揭示了炎症性疾病和心血管疾病背后的共同机制,并阐明了 RA 中涉及的代谢和心血管途径以及不同药物治疗的作用。应在所有 RA 患者中强制进行心血管风险评估,同时考虑到两种疾病对患者预后的影响。因此,多学科方法是最佳的管理方法,风湿病学家、心脏病学家和全科医生必须共同努力,以显著改善 RA 患者的预后和生活质量。未来的研究可以探讨更积极地治疗心血管和代谢危险因素的潜在有益效果。