ReviewCardiovascular disease in autoimmune rheumatic diseases
Section snippets
Atherosclerosis in autoimmune rheumatic diseases (ARDs)
ARDs are associated with a wide range of cardiovascular pathologies. Of these, atherothrombosis, particularly in the form of coronary artery disease (CAD), has the greatest clinical impact because it is the main cause of premature mortality in most ARDs [1]. Therefore, there is an enormous need to incorporate cardiovascular (CV) prevention, detection and treatment strategies in the care of patients with of ARDs in a similar way as has happened in the management of diabetes, with the aim to
Factors contributing to CVD in ARDs
Besides traditional CV risk factors, a variety of other factors are likely to contribute to the increased CV risk in ARDs. In this review, we will concentrate especially on some of the potential mechanisms that have so far received relatively little attention in the literature.
Cardiovascular prophylaxis in ARDs
Although the high CV risk in ARDs has been known for a long time, many ARD patients still do not receive appropriate CV prevention and treatment. This failing likely has several explanations. Many rheumatologists traditionally focus on the treatment of musculoskeletal symptoms or other disease-specific complications of ARDs rather than on CV prophylaxis. Moreover, there is clearly limited general awareness of CV risk in ARDs. Furthermore, CVD in ARDs is often difficult to diagnose because of
Take-home messages
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ARDs are associated with an increased CV risk due to traditional and non-traditional CV risk factors. Some of these factors include vascular inflammation, depression, sleep apnea, vitamin D deficiency and disturbances in EC function.
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Infections and autoimmunity may contribute to the vascular inflammation and endothelial cell impairment that might be involved in the pathogenesis of CVD, and of accelerated CVD in ARDs.
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Vascular inflammation and complement depositions may substantially contribute to
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