期刊
NATURE REVIEWS RHEUMATOLOGY
卷 11, 期 7, 页码 390-400出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/nrrheum.2015.40
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资金
- Arthritis Research UK
- Manchester Academic Health Science Centre
- NIHR Manchester Musculoskeletal Biomedical Research Unit
- NIHR Manchester Wellcome Trust Clinical Research Facility
- North West England Medical Research Council Fellowship Scheme in Clinical Pharmacology and Therapeutics
- Manchester Biomedical Research Centre
- Medical Research Council [G1000417/94909]
- MRC [G1000417] Funding Source: UKRI
- Medical Research Council [G1000417] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10105] Funding Source: researchfish
Rheumatoid arthritis (RA) has long been associated with increased cardiovascular risk, but despite substantial improvements in disease management, mortality remains high. Atherosclerosis is more prevalent in RA than in the general population, and atherosclerotic lesions progress at a faster rate and might be more prone to rupture, causing clinical events. Cells and cytokines implicated in RA pathogenesis are also involved in the development and progression of atherosclerosis, which is generally recognized as an inflammatory condition. The two diseases also share genetic and environmental risk factors, which suggests that patients who develop RA might also be predisposed to developing cardiovascular disease. In RA, inflammation and atherosclerosis are closely linked. Inflammation mediates its effects on atherosclerosis both through modulation of traditional risk factors and by directly affecting the vessel wall. Treatments such as TNF inhibitors might have a beneficial effect on cardiovascular risk. However, whether this benefit is attributable to effective control of inflammation or whether targeting specific cytokines, implicated in atherosclerosis, provides additional risk reduction is unclear. Further knowledge of the predictors of cardiovascular risk, the effects of early control of inflammation and of drug-specific effects are likely to improve the recognition and management of cardiovascular risk in patients with RA.
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