title: Cardiovascular risk in rheumatic patients: the link between inflammation and atherothrombosis.
abstract: In addition to a high prevalence of the metabolic syndrome and a significant under-diagnosis of vascular risk factors (VRFs), the effect of chronic inflammation also represents the cornerstone of the raised cardiovascular (CV) risk in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Moreover, the finding that among current anti-inflammatory treatments, the use of tumor necrosis factor (TNF)-α blockers is associated with optimal rheumatologic and CV outcomes further supports the impact of inflammation on the CV risk. However, up-to-date treatment guidelines suggest that TNF-α blockers should be used only after the failure of traditional disease-modifying antirheumatic drugs (DMARDs). Early predictors of the therapeutic efficacy of traditional DMARDs are needed to identify candidates for TNF-α blocker treatment. Furthermore, whether the CV risk should be taken into account while choosing antirheumatic treatments is an emerging issue to be addressed. Common educational programs for specialists and general practitioners and appropriate CV prevention programs, taking into consideration traditional VRFs as well as the inflammatory status, should be planned to prevent ischemic events and to achieve optimal inflammation control in rheumatic patients.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
authors.forename: Matteo Nicola Dario
authors.initials: MN
authors.lastname: Di Minno
authors.forename: Salvatore
authors.initials: S
authors.lastname: Iervolino
authors.forename: Roberta
authors.initials: R
authors.lastname: Lupoli
authors.forename: Anna
authors.initials: A
authors.lastname: Russolillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Coppola
authors.forename: Rosario
authors.initials: R
authors.lastname: Peluso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Minno
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000473:pathology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000188:drug therapy / Q000473:pathology*; D012216:Rheumatic Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012307:Risk Factors; D013927:Thrombosis / Q000188:drug therapy / Q000473:pathology*
chemical_list: D018501:Antirheumatic Agents