Substantial epidemiological data identified cardiovascular (CV) diseases as a main cause of mortality in patients with rheumatoid arthritis (RA). In light of this, RA patients may benefit from additional CV risk screening and more intensive prevention strategies. Nevertheless, current algorithms for CV risk stratification still remain tailored on general population and are burdened by a significant underestimation of CV risk in RA patients. Acute CV events in patients with RA are largely related to an accelerated atherosclerosis. As pathophysiological features of atherosclerosis overlap those occurring in the inflamed RA synovium, the understanding of those common pathways represents an urgent need and a leading challenge for CV prevention in patients with RA. Genetic background, metabolic status, gut microbiome, and systemic inflammation have been also suggested as additional key pro-atherosclerotic factors. The aim of this narrative review is to update the current knowledge about pathophysiology of atherogenesis in RA patients and potential anti-atherosclerotic effects of disease-modifying anti-rheumatic drugs.

中文翻译：

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类风湿关节炎的动脉粥样硬化：促进剂和对手。

大量的流行病学数据表明，心血管疾病是类风湿关节炎（RA）患者死亡的主要原因。有鉴于此，RA患者可能会从额外的CV风险筛查和更深入的预防策略中受益。尽管如此，当前的CV风险分层算法仍是针对一般人群量身定制的，并且严重低估了RA患者的CV风险。RA患者的急性CV事件在很大程度上与动脉粥样硬化的加速有关。由于动脉粥样硬化的病理生理学特征与发炎的RA滑膜中发生的那些重叠，对这些常见途径的理解代表了RA患者CV预防的迫切需求和主要挑战。遗传背景，代谢状态，肠道微生物组，还提示全身性炎症和全身性炎症是动脉粥样硬化的其他关键因素。这篇叙述性综述的目的是为了更新有关RA患者动脉粥样硬化的病理生理学知识以及改变疾病的抗风湿药的潜在抗动脉粥样硬化作用的知识。