Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, Madrid, Spain.
Department of Medicine, Cátedra UAM-ROCHE, EPID Future, Universidad Autónoma de Madrid (UAM), Madrid, Spain.
Expert Rev Clin Immunol. 2020 Jan;16(1):23-36. doi: 10.1080/1744666X.2019.1699058. Epub 2019 Dec 10.
: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.
炎症性关节病（IJDs）患者（如类风湿关节炎、强直性脊柱炎和银屑病关节炎）心血管（CV）发病率和死亡率增加。然而，这些情况下的 CV 疾病管理远未得到很好的确定。
本综述总结了与 IJD 相关的 CV 疾病的主要流行病学、病理生理学和临床风险因素。还讨论了这些情况下 CV 疾病早期诊断和风险分层的不常见方面。在欧洲，IJDs 患者最常用的风险算法是基于 2017 年 EULAR 工作组提出的修订建议的改良 SCORE 指数。
早期识别 CV 疾病风险高的 IJD 患者至关重要。它应包括使用补充的非侵入性成像技术。旨在改善心脏健康习惯的多学科方法至关重要，包括严格控制经典 CV 风险因素。适当的 IJD 基础治疗也很重要，因为降低疾病活动度可降低 CV 事件的风险。非甾体抗炎药（NSAIDs）在 IJD 中的危害可能小于普通人群，这是由于其抗炎作用以及其他潜在的有益作用。
