St. George's University of London, London, United Kingdom.
National Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Curr Vasc Pharmacol. 2020;18(6):580-591. doi: 10.2174/1570161118666200408121307.
Juvenile idiopathic arthritis (JIA), is a term used to describe a group of inflammatory disorders beginning before the age of 16 years. Although for the majority of children remission is achieved early, those with systemic or polyarticular form of the disease may present persistent symptoms in adulthood. Considering that there is overlap in the pathogenesis of JIA with adult rheumatic diseases, concerns have been raised as to whether JIA patients could be at increased cardiovascular (CV) risk in the long-term. In this review, we summarize evidence for CV involvement in JIA and present data on CV risk factors and surrogate markers of arterial disease. We also provide information on beneficial and harmful CV effects of anti-inflammatory medications in the context of JIA and suggest strategies for CV screening. Overall, patients with systemic forms of JIA demonstrate an adverse lipid profile and early arterial changes relevant to accelerated arterial disease progression. Although there is paucity of data on CV outcomes, we recommend a holistic approach in the management of JIA patients, which includes CV risk factor monitoring and lifestyle modification as well as use, when necessary, of antiinflammatory therapies with documented CV safety.
幼年特发性关节炎（JIA）是用于描述一组在 16 岁之前开始的炎症性疾病。尽管对于大多数儿童来说，早期即可达到缓解，但患有全身性或多发性疾病的儿童在成年后可能仍存在持续的症状。由于 JIA 的发病机制与成人风湿性疾病重叠，因此人们担心 JIA 患者在长期内是否会增加心血管（CV）风险。在这篇综述中，我们总结了 JIA 患者心血管受累的证据，并介绍了心血管危险因素和动脉疾病的替代标志物的数据。我们还提供了有关抗炎药物在 JIA 背景下对心血管有益和有害影响的信息，并提出了心血管筛查的策略。总体而言，患有全身性 JIA 的患者表现出不良的血脂谱和与动脉疾病加速进展相关的早期动脉变化。尽管关于心血管结局的数据很少，但我们建议对 JIA 患者进行整体治疗，包括监测心血管危险因素和生活方式的改变，以及在必要时使用具有明确心血管安全性的抗炎治疗。
