REVIEW - Cardiovascular disease in RA

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Curr Opin Rheumatol. 2006 May;18(3):289-97.

Cardiovascular disease in rheumatoid arthritis.

Kaplan MJ.

Division of Rheumatology, University of Michigan Medical School, Ann Arbor,

Michigan, USA.

PURPOSE OF REVIEW: Individuals with rheumatoid arthritis are at increased

risk for morbidity and mortality from cardiovascular disease (CVD). The

purpose of this review is to discuss recent advances in our understanding of

the pathogenesis, prevalence, treatment, and prevention of accelerated

atherosclerotic disease in rheumatoid arthritis. RECENT FINDINGS: Recent

reports have highlighted the increased risk for silent myocardial infarction

and sudden death in rheumatoid arthritis, and the potential roles of

traditional and nontraditional risk factors for CVD, including abnormal

revascularization of damaged peripheral blood vessels and genetic

polymorphisms. Several studies have also added important information on the

possible role of anti-tumor necrosis factor-alpha therapy, other disease

modifying antirheumatic drugs, and nonsteroidal anti-inflammatory drugs in

decreasing CVD risk.

SUMMARY: The pathogenic mechanisms involved in accelerated cardiovascular

complications in rheumatoid arthritis appear to be complex and

multifactorial. Both traditional and nontraditional risk factors potentially

contribute to the increased cardiovascular risk. Good control of the

inflammation, immunologic disturbances, and metabolic changes seen in

rheumatoid arthritis are crucial in the prevention of this potentially

lethal complication. There is a need for heightened awareness of the

increased risk for silent ischemia, early myocardial infarction, and sudden

death. Further exploration of the mechanisms of vascular repair and their

potential role in premature atherosclerosis is needed.

PMID: 16582694

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6582694 & dopt=Abstract

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Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org