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Atherosclerosis in Rheumatoid Arthritis: Promoters and Opponents.

Authors
  • Carbone, Federico1
  • Bonaventura, Aldo1
  • Liberale, Luca1, 2
  • Paolino, Sabrina3, 4
  • Torre, Francesco4, 5
  • Dallegri, Franco1, 6
  • Montecucco, Fabrizio6, 7
  • Cutolo, Maurizio8, 9
  • 1 First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy. , (Italy)
  • 2 Center for Molecular Cardiology, University of Zürich, 12 Wagistrasse, 8952, Schlieren, Switzerland. , (Switzerland)
  • 3 Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, San Martino Polyclinic Hospital, Genoa, Italy. , (Italy)
  • 4 IRCCS Ospedale Policlinico San Martino Genoa, 10 Largo Benzi, 16132, Genoa, Italy. , (Italy)
  • 5 Clinic of Emergency Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy. , (Italy)
  • 6 IRCCS Ospedale Policlinico San Martino Genoa-Italian Cardiovascular Network, 10 Largo Benzi, 16132, Genoa, Italy. , (Italy)
  • 7 First Clinic of Internal Medicine, Department of Internal Medicine and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy. , (Italy)
  • 8 IRCCS Ospedale Policlinico San Martino Genoa, 10 Largo Benzi, 16132, Genoa, Italy. [email protected] , (Italy)
  • 9 Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, San Martino Polyclinic Hospital, Genoa, Italy. [email protected] , (Italy)
Type
Published Article
Journal
Clinical Reviews in Allergy & Immunology
Publisher
Springer-Verlag
Publication Date
Feb 01, 2020
Volume
58
Issue
1
Pages
1–14
Identifiers
DOI: 10.1007/s12016-018-8714-z
PMID: 30259381
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Substantial epidemiological data identified cardiovascular (CV) diseases as a main cause of mortality in patients with rheumatoid arthritis (RA). In light of this, RA patients may benefit from additional CV risk screening and more intensive prevention strategies. Nevertheless, current algorithms for CV risk stratification still remain tailored on general population and are burdened by a significant underestimation of CV risk in RA patients. Acute CV events in patients with RA are largely related to an accelerated atherosclerosis. As pathophysiological features of atherosclerosis overlap those occurring in the inflamed RA synovium, the understanding of those common pathways represents an urgent need and a leading challenge for CV prevention in patients with RA. Genetic background, metabolic status, gut microbiome, and systemic inflammation have been also suggested as additional key pro-atherosclerotic factors. The aim of this narrative review is to update the current knowledge about pathophysiology of atherogenesis in RA patients and potential anti-atherosclerotic effects of disease-modifying anti-rheumatic drugs.

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