Background and Significance
Cardiovascular disease is the greatest risk patients with Rheumatoid Arthritis face.
Studies that examine cardiovascular inflammation in RA patients are lacking.
Traditional tools to predict cardiovascular risk do not apply well to RA patients.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can be disabling and increases a patient's risk of mortality by 1.5-3 times. Cardiovascular disease (CVD) has been consistently identified as the leading cause of excess deaths in RA. Despite marked improvements in survival in the general US population in the past 2-3 decades, RA-associated mortality rates have not declined.
Numerous studies indicate that traditional risk factors for CVD do not fully account for the increased risk for CVD in RA. Atherosclerosis in the general population is recognized as a low-grade inflammatory process. Chronic inflammation in RA likely accelerates atherosclerosis and plaque rupture in RA, but whether this is due to greater inflammation throughout the body including the veins and arteries, greater inflammation within veins and arteries themselves, or both remains to be determined.
In the general population, Cardiovascular disease (CVD) risk prediction tools have been developed to estimate an individual’s future risk for a CV event. While these risk tools perform well at the population level, they cannot predict risk in individuals, especially women and younger individuals, groups heavily represented in RA. In fact, one study reported that CVD risk is 2-fold higher in women with RA and 65% higher in men with RA than predicted for the general population.