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Unmet needs in the management of cardiovascular risk in inflammatory joint diseases.
Expert Review of Clinical Immunology ( IF 3.9 ) Pub Date : 2019-12-10 , DOI: 10.1080/1744666x.2019.1699058
Santos Castañeda 1, 2 , Esther F Vicente-Rabaneda 1 , Noelia García-Castañeda 1 , Diana Prieto-Peña 3 , Patrick H Dessein 4 , Miguel A González-Gay 3, 5, 6
Affiliation  

Introduction: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.Areas covered: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.Expert opinion: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.

中文翻译:

炎症性关节疾病心血管风险管理方面的需求未得到满足。

介绍:在炎症性关节病 (IJD) 中观察到心血管 (CV) 发病率和死亡率增加,例如类风湿性关节炎、强直性脊柱炎和银屑病关节炎。然而,在这些情况下,CV 疾病的管理远未完善。涵盖的领域:本综述总结了与 IJD 相关的 CV 疾病的主要流行病学、病理生理学和临床危险因素。还讨论了在这些情况下心血管疾病早期诊断和风险分层的不太常见的方面。在欧洲,IJDs患者最常用的风险算法是基于2017年EULAR工作组提出的修订建议修改后的SCORE指数。 专家意见:早期识别具有CV疾病高风险的IJD患者至关重要。它应该包括使用互补的无创成像技术。旨在改善心脏健康习惯的多学科方法,包括严格控制经典的心血管风险因素至关重要。对基础 IJD 的充分管理也很重要,因为疾病活动的减少会降低 CV 事件的风险。由于非甾体抗炎药具有抗炎作用以及其他潜在的有益作用,因此与普通人群相比,非甾体抗炎药对 IJD 的有害作用可能较小。
更新日期:2019-11-01
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