Poznyak Anastasia V, Orekhov Nikolay A, Churov Alexey V, Starodubtseva Irina Alexandrovna, Beloyartsev Dmitry Felixovich, Kovyanova Tatiana Ivanovna, Sukhorukov Vasily N, Orekhov Alexander N
Institute for Atherosclerosis Research, Moscow, Russia.
Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia.
SAGE Open Med. 2025 Jul 23;13:20503121251330171. doi: 10.1177/20503121251330171. eCollection 2025.
Rheumatoid arthritis significantly increases the risk of cardiovascular disease due to chronic inflammation. This review's purpose is to critically analyze the intricate relationship between rheumatoid arthritis and cardiovascular disease, highlighting the mechanisms by which systemic inflammation contributes to cardiovascular risk and the effectiveness of current treatment strategies. We systematically evaluate existing literature on conventional cardiovascular risk factors in rheumatoid arthritis patients, as well as inflammation-specific markers that influence cardiovascular outcomes. Our conclusions indicate that while several treatment modalities, including methotrexate and other disease-modifying agents, may mitigate cardiovascular risk, there is a prevalent underestimation of true risk by standard cardiovascular disease assessment protocols. This review provides unique contributions by emphasizing the importance of integrating novel risk factors into assessment protocols and advocating for personalized management strategies that cater to the specific needs of rheumatoid arthritis patients. By synthesizing these elements, we aim to enhance understanding and guide clinicians in improving outcomes for rheumatoid arthritis patients at heightened risk of cardiovascular complications.
类风湿关节炎由于慢性炎症会显著增加心血管疾病的风险。本综述的目的是批判性地分析类风湿关节炎与心血管疾病之间的复杂关系,强调全身炎症导致心血管风险的机制以及当前治疗策略的有效性。我们系统地评估了关于类风湿关节炎患者传统心血管危险因素的现有文献,以及影响心血管结局的炎症特异性标志物。我们的结论表明,虽然包括甲氨蝶呤和其他改善病情的药物在内的几种治疗方式可能会降低心血管风险,但标准的心血管疾病评估方案普遍低估了真正的风险。本综述通过强调将新的危险因素纳入评估方案的重要性,并倡导针对类风湿关节炎患者的特定需求制定个性化管理策略,做出了独特的贡献。通过综合这些要素,我们旨在增进理解并指导临床医生改善有心血管并发症高风险的类风湿关节炎患者的治疗效果。