Nagy Stephanie, Ditchek Jordan, Kesselman Marc M
Rheumatology, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA.
Radiology, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, USA.
Cureus. 2024 Sep 30;16(9):e70517. doi: 10.7759/cureus.70517. eCollection 2024 Sep.
Rheumatoid arthritis (RA) is one of the leading autoimmune causes of inflammatory arthropathy worldwide. The musculoskeletal impacts of RA are well described within the literature. More recently, research efforts have highlighted that inflammation associated with the condition is not solely isolated to the joint synovium. Specifically, data has demonstrated that the cardiovascular system is negatively impacted by inflammation tied to RA, with adverse cardiovascular outcomes considered the leading cause of mortality among patients with RA. One approach to determine the risk for cardiovascular disease (CVD) is computed tomography (CT) coronary angiography, a noninvasive imaging approach that analyzes the calcifications within the coronary vessels. This has increasingly been utilized to analyze plaque burden and vessel obstruction, which is measured using the coronary artery calcium (CAC) score. A total of 305 articles were analyzed, and 11 articles were selected for this review based on inclusion and exclusion criteria. The results indicated that nearly 60% of patients with RA experienced an elevated CAC score. As such, patients with RA likely carry a higher risk for adverse cardiovascular outcomes as compared to their healthy counterparts. Additional research is warranted based on these findings to determine whether the addition of CT coronary angiography and analysis of laboratory markers for CVD, including lipid markers in standard protocols for RA comorbid assessment, would help to reduce adverse cardiovascular complications.
类风湿性关节炎（RA）是全球范围内导致炎症性关节病的主要自身免疫病因之一。RA对肌肉骨骼的影响在文献中有充分描述。最近，研究工作强调与该病症相关的炎症并非仅局限于关节滑膜。具体而言，数据表明心血管系统会受到与RA相关炎症的负面影响，不良心血管结局被认为是RA患者死亡的主要原因。确定心血管疾病（CVD）风险的一种方法是计算机断层扫描（CT）冠状动脉造影，这是一种分析冠状动脉内钙化的非侵入性成像方法。这种方法越来越多地用于分析斑块负荷和血管阻塞情况，血管阻塞情况通过冠状动脉钙化（CAC）评分来衡量。共分析了305篇文章，并根据纳入和排除标准选择了11篇文章进行本综述。结果表明，近60%的RA患者CAC评分升高。因此，与健康人相比，RA患者可能发生不良心血管结局的风险更高。基于这些发现，有必要进行更多研究，以确定在RA合并症评估的标准方案中增加CT冠状动脉造影和分析CVD实验室标志物（包括脂质标志物）是否有助于减少不良心血管并发症。
