title: Cardiovascular risk assessment in patients with rheumatoid arthritis: The relevance of clinical, genetic and serological markers.
abstract: Cardiovascular disease (CV) is the most common cause of premature mortality in patients with rheumatoid arthritis (RA). This is the result of an accelerated atherosclerotic process. Adequate CV risk stratification has special relevance in RA to identify patients at risk of CV disease. However, current CV risk screening and management strategies underestimate the actual CV risk in RA. Consequently, the search for additional tools that may help to identify those patients at high CV risk has become a key objective in the last years. In this regard, non-invasive surrogates, such as carotid ultrasonography, have been found to be excellent predictors of future CV events. In addition, several studies have revealed the relevance of a genetic component in the development of CV disease in RA patients. Besides an association with HLA-DRB1* shared epitope alleles other gene polymorphisms located inside and outside the HLA seem to influence the risk of cardiovascular disease in RA. Moreover, serum levels of some metabolic syndrome-related biomarkers, adipokines such as adiponectin and biomarkers of endothelial cell activation and inflammation such as Osteoprotegerin and Asymmetric dimethylarginine have recently been found useful for the prediction of CV disease in these patients. An update of the current knowledge on these potential markers, especially focused on new genetic and serological biomarkers is shown in this review.
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: López-Mejías
authors.affiliation: Division of Rheumatology, Hospital Universitario la Princesa, IIS-IPrincesa, Madrid, Spain.
authors.forename: Santos
authors.initials: S
authors.lastname: Castañeda
authors.affiliation: Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Corrales
authors.affiliation: Rheumatology Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Iván
authors.initials: I
authors.lastname: Ferraz-Amaro
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Genre
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Remuzgo-Martínez
authors.affiliation: Division of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodriguez-Rodriguez
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, and CIBER Epidemiología y Salud Pública (CIBERESP), IDIVAL, Santander, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.affiliation: Institute of Parasitology and Biomedicine López-Neyra, IPBLN-CSIC, Granada, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Martín
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain; School of Medicine, University of Cantabria, Santander, Spain; Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: miguelaggay@hotmail.com.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D059811:HLA-DRB1 Chains; D018836:Inflammation Mediators
keywords: Atherosclerosis; Cardiovascular risk; Carotid ultrasonography; Genetics; Rheumatoid arthritis; Serum biomarkers