Kattamuri Lakshmi, Duggal Shivangini, Aparece John Paul, Sairam Shrilekha
Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, 4800 Alberta Ave, El Paso, TX, 79935, USA.
Division of Rheumatology, Department of Internal Medicine, Texas Tech Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX, USA.
Curr Cardiol Rep. 2025 Jan 20;27(1):31. doi: 10.1007/s11886-025-02198-8.
To highlight advancements in managing traditional and rheumatoid arthritis (RA) specific risk factors and the impact of RA treatments on cardiovascular outcomes.
Advancements in rheumatoid arthritis management have paralleled declining trends in cardiovascular disease risks. Biomarkers like CRP, Lipoprotein(a), Apolipoprotein B 100, and imaging tools such as coronary artery calcium scoring enhance cardiovascular risk stratification, particularly in intermediate-risk RA patients. While effective RA treatments, have demonstrated substantial cardiovascular benefits, subclass differences were noted in high-risk patients. Increased risk of cardiovascular disease is driven by chronic inflammation, altered lipid metabolism, and traditional risk factors. Effective RA treatment significantly lowers cardiovascular events. Standard treatment of hypertension, diabetes and hypercholesterolemia are effective and lowers RA disease activity and inflammatory markers. While RA is considered a risk enhancing state in calculating CV risk scores, currently there exists no RA disease -specific blood pressure, blood sugar or lipid targets.
强调在管理传统和类风湿关节炎（RA）特定风险因素方面的进展以及RA治疗对心血管结局的影响。
类风湿关节炎管理方面的进展与心血管疾病风险的下降趋势并行。像CRP、脂蛋白（a）、载脂蛋白B 100这样的生物标志物以及诸如冠状动脉钙化评分等成像工具可增强心血管风险分层，尤其是在中度风险的RA患者中。虽然有效的RA治疗已显示出显著的心血管益处，但在高风险患者中注意到了亚类差异。心血管疾病风险增加是由慢性炎症、脂质代谢改变和传统风险因素驱动的。有效的RA治疗可显著降低心血管事件。高血压、糖尿病和高胆固醇血症的标准治疗是有效的，可降低RA疾病活动度和炎症标志物。虽然在计算心血管风险评分时RA被视为风险增强状态，但目前不存在RA疾病特异性的血压、血糖或血脂目标。
