期刊
BMJ-BRITISH MEDICAL JOURNAL
卷 361, 期 -, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmj.k1036
关键词
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资金
- University of Nebraska Medical Center (UNMC) internal medicine scientist development award
- UNMC Mentored Scholars Program
- UNMC College of Medicine Physician-Scientist Training Program
- National Institutes of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin Diseases [P50AR060772]
- National Institute of Alcohol Abuse and Alcoholism [R25AA020818]
- National Institute of General Medical Sciences [U54GM115458]
- Veterans Affairs Office of Research and Development [CX000896]
- Bristol Myers Squibb
- Ironwood Pharmaceuticals
- Harry R and Sarah H Caspersen Coronary Artery Disease Research Fund
- Division of Cardiovascular Medicine, Department of Internal Medicine, UNMC
- Rheumatology Research Foundation
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [P50AR060772] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [U54GM115458] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM [R25AA020818] Funding Source: NIH RePORTER
Rheumatoid arthritis is a systemic autoimmune disease characterized by excess morbidity and mortality from cardiovascular disease. Mechanisms linking rheumatoid arthritis and cardiovascular disease include shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, alterations in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction. Despite a growing understanding of these mechanisms and their complex interplay with conventional cardiovascular risk factors, optimal approaches of risk stratification, prevention, and treatment in the context of rheumatoid arthritis remain unknown. A multifaceted approach to reduce the burden posed by cardiovascular disease requires optimal management of traditional risk factors in addition to those intrinsic to rheumatoid arthritis such as increased disease activity. Treatments for rheumatoid arthritis seem to exert differential effects on cardiovascular risk as well as the mechanisms linking these conditions. More research is needed to establish whether preferential rheumatoid arthritis therapies exist in terms of prevention of cardiovascular disease. Ultimately, understanding the unique mechanisms for cardiovascular disease in rheumatoid arthritis will aid in risk stratification and the identification of novel targets for meaningful reduction of cardiovascular risk in this patient population.
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