Cor Vasa 2006, 48(2):68-71 | DOI: 10.33678/cor.2006.024

Are rheumatoid arthritis and other autoimmune rheumatic diseases a risk factor for atherosclerosis?

Jan Piťha^1,*, Radim Bečvář², Štefan Alušík³

¹ Katedra interního lékařství IPVZ, Laboratoř pro výzkum aterosklerózy, Institut klinické a experimetnální medicíny

² Revmatologická klinika, 1. lékařská fakulta Univerzity Karlovy

³ Katedra interního lékařství IPVZ, I. interní klinika Fakultní Thomayerovy nemocnice, Praha, Česká republika

Atherosclerosis is defined as an inflammatory disease. The main risk factor triggering the process is a high level of LDL particles and their subsequent modification in the vessel wall. A most important role is subsequently played by the cellular and hormonal components of the immune system; they may become the key factor in the process of atherosclerosis, e. g., in autoimmune diseases such as rheumatoid arthritis and other conditions. These conditions have been shown to be as-sociated with an increased incidence of clinical cardiovascular events and pre-clinical atherosclerosis. The favorable effect on conventional risk factors of atherosclerosis in these conditions, in particular lipid-lowering therapy using 3-methyl 3-glutaryl CoA-reductase inhibitors (statins), appears to be most beneficial. By contrast, treatment of the atherosclerotic process using novel anti-inflammatory drugs, and tumor necrotizing factor-a in particular, continues to be a matter of controversy; under certain circumstances, it may result, apparently via the rebound phenomenon, in deterioration of circulatory parameters, and endothelial function in particular. This potentially detrimental effect is demonstrated in a case report making part of the paper.

Keywords: Atherosclerosis; Autoimmune rheumatic disease; Lipid-lowering therapy; Anti-inflammatory therapy

Published: February 1, 2006  Show citation