Popescu Diana, Rezus Elena, Badescu Minerva Codruta, Dima Nicoleta, Seritean Isac Petronela Nicoleta, Dragoi Ioan-Teodor, Rezus Ciprian
Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania.
Internal Medicine Clinic, "Sf. Spiridon" County Clinical Emergency Hospital, 700111 Iasi, Romania.
Life (Basel). 2023 Jan 23;13(2):319. doi: 10.3390/life13020319.
Rheumatoid arthritis (RA), one of the most common of the chronic inflammatory autoimmune diseases (CIADs), is recognized as an independent cardiovascular risk factor. Traditional risk factors such as smoking, arterial hypertension, dyslipidemia, insulin resistance, and obesity are frequently found in RA. Given the increased risk of mortality and morbidity associated with cardiovascular disease (CVD) in RA patients, screening for risk factors is important. Moreover, there is a need to identify potential predictors of subclinical atherosclerosis. Recent studies have shown that markers such as serum homocysteine, asymmetric dimethylarginine, or carotid intima-media thickness (cIMT) are correlated with cardiovascular risk. Although RA presents a cardiovascular risk comparable to that of diabetes, it is not managed as well in terms of acute cardiovascular events. The introduction of biological therapy has opened new perspectives in the understanding of this pathology, confirming the involvement and importance of the inflammatory markers, cytokines, and the immune system. In addition to effects in inducing remission and slowing disease progression, most biologics have demonstrated efficacy in reducing the risk of major cardiovascular events. Some studies have also been conducted in patients without RA, with similar results. However, early detection of atherosclerosis and the use of targeted therapies are the cornerstone for reducing cardiovascular risk in RA patients.
类风湿关节炎（RA）是最常见的慢性炎症性自身免疫性疾病（CIADs）之一，被认为是一种独立的心血管危险因素。RA患者中经常出现吸烟、动脉高血压、血脂异常、胰岛素抵抗和肥胖等传统危险因素。鉴于RA患者心血管疾病（CVD）相关的死亡和发病风险增加，筛查危险因素很重要。此外，有必要识别亚临床动脉粥样硬化的潜在预测指标。最近的研究表明，血清同型半胱氨酸、不对称二甲基精氨酸或颈动脉内膜中层厚度（cIMT）等标志物与心血管风险相关。尽管RA的心血管风险与糖尿病相当，但在急性心血管事件方面的管理却不尽如人意。生物疗法的引入为理解这种病理状况开辟了新的视角，证实了炎症标志物、细胞因子和免疫系统的参与及重要性。除了诱导缓解和减缓疾病进展的作用外，大多数生物制剂在降低主要心血管事件风险方面已显示出疗效。一些研究也在非RA患者中进行，结果相似。然而，早期发现动脉粥样硬化并使用靶向治疗是降低RA患者心血管风险的基石。
