St. George's University School of medicine, True Blue, St. George's, Grenada.
University of Maryland Medical Center MTC, Midtown, Baltimore, USA.
F1000Res. 2022 Apr 27;11:466. doi: 10.12688/f1000research.112921.2. eCollection 2022.
Rheumatoid arthritis (RA) is a highly prevalent, chronic inflammatory condition of the synovial joints that affects approximately 1% of the global population. The pathogenesis of RA is predominantly inflammatory in nature, thereby accelerating the co-occurrence of other immunoinflammatory conditions such as atherosclerosis. Apart from traditional cardiovascular risk factors, RA patients possess a multitude of other factors that predispose them to early atherosclerotic disease. The aim of this systematic review is to assess the prevalence of premature atherosclerosis in RA patients and elucidate the role that proinflammatory cytokines, RA-related autoantibodies, and endothelial dysfunction play in the pathophysiology of RA-mediated atherosclerosis. We also discussed novel biomarkers that can be used to predict early atherosclerosis in RA and current guidelines used to treat RA. This review followed the PRISMA guidelines to select and analyze relevant articles. A literature search for articles was performed on February 25, 2022, through three research databases including PubMed, ProQuest, and ScienceDirect. The query used to identify relevant publications was "Rheumatoid arthritis and atherosclerosis" and the search duration was set from 2012-2022. Relevant articles were selected based on the inclusion and exclusion criteria. Our initial search generated 21,235 articles. We narrowed our search according to the inclusion and exclusion criteria. After assessing eligibility based on the full content of the articles, 73 articles were ultimately chosen for this review. There is an increased prevalence of accelerated atherosclerosis among RA patients. We found evidence to explain the role of proinflammatory cytokines, RA-related autoantibodies, and endothelial dysfunction in the pathophysiology RA-mediated atherosclerosis. Therapies targeting either the inflammatory load or traditional CV risk-factors seem to improve vascular outcomes in RA patients. Novel markers of atherosclerosis in RA may be useful in predicting premature atherosclerosis and serve as new targets for therapeutic intervention.
类风湿关节炎（RA）是一种常见的、慢性炎症性滑膜关节疾病，影响全球约 1%的人口。RA 的发病机制主要为炎症性质，从而加速了动脉粥样硬化等其他免疫炎症性疾病的共同发生。除了传统的心血管危险因素外，RA 患者还存在多种其他因素，使他们易患早期动脉粥样硬化疾病。本系统评价的目的是评估 RA 患者发生早发性动脉粥样硬化的患病率，并阐明促炎细胞因子、RA 相关自身抗体和内皮功能障碍在 RA 介导的动脉粥样硬化发病机制中的作用。我们还讨论了可用于预测 RA 早期动脉粥样硬化的新型生物标志物和目前用于治疗 RA 的指南。本综述遵循 PRISMA 指南选择和分析相关文章。于 2022 年 2 月 25 日通过 PubMed、ProQuest 和 ScienceDirect 三个研究数据库进行了针对相关文章的文献检索。用于识别相关出版物的查询词为“类风湿关节炎和动脉粥样硬化”，搜索时间范围设定为 2012-2022 年。根据纳入和排除标准选择相关文章。我们的初步搜索生成了 21235 篇文章。我们根据纳入和排除标准缩小了搜索范围。根据文章全文评估了资格后，最终选择了 73 篇文章进行综述。RA 患者加速动脉粥样硬化的患病率增加。我们发现了证据，可以解释促炎细胞因子、RA 相关自身抗体和内皮功能障碍在 RA 介导的动脉粥样硬化发病机制中的作用。针对炎症负荷或传统心血管危险因素的治疗似乎可以改善 RA 患者的血管结局。RA 中动脉粥样硬化的新型标志物可能有助于预测早发性动脉粥样硬化，并可作为治疗干预的新靶点。
