• Dtsch. Med. Wochenschr. · Apr 2021

    [Rheumatic diseases, inflammation and cardiovascular risk].

    • Phuong Nguyen and Christoph Baerwald.
    • Bereich Rheumatologie, Klinik und Poliklinik für Endokrinologie, Nephrologie und Rheumatologie, Universitätsklinikum Leipzig.
    • Dtsch. Med. Wochenschr. 2021 Apr 1; 146 (7): 474-477.

    AbstractCARDIOVASCULAR RISK PROFILE OF PATIENTS WITH INFLAMMATORY ARTHRITIS:  Patients with inflammatory arthritis have an increased risk of cardiovascular disease compared to the general population. The discovery of this fact dates back to over a decade ago, but cardiovascular morbidity and mortality in these patients have not yet significantly improved. In 2021, the management of cardiovascular risk in patients with inflammatory arthritis remains an important aspect for general practitioners, rheumatologists and researchers. CARDIOVASCULAR RISK ASSESSMENT:  Risk scores used for the general population often underestimate the increased cardiovascular risk in patients with inflammatory arthritis. Inflammation was repeatedly found to be an independent cardiovascular risk factor. However, attempts to incorporate inflammation markers into risk scores has not yielded an improved risk prediction so far. Further studies need to investigate the influence of disease-specific factors like disease activity or treatment effect on cardiovascular risk. Currently, there is no independent risk assessment specifically established for patients with inflammatory arthritis. INFLUENCE OF ANTIRHEUMATIC DRUGS ON CARDIOVASCULAR RISK: Antirheumatic drugs can modify cardiovascular risk. The most pronounced protective effect was found in biologics. Tumor necrosis factor α inhibitors, for instance, reduce cardiovascular event rate by 15 %. Data on methotrexate is less robust but also suggests a protective effect in patients with inflammatory arthritis. Studies on the relatively new janus kinase inhibitors are expected to provide new data in the coming years.Thieme. All rights reserved.

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