The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Bloody Important: Atherosclerosis & Thrombotic Disease in Rheumatic Conditions

Bloody Important: Atherosclerosis & Thrombotic Disease in Rheumatic Conditions

August 19, 2020 • By Jason Liebowitz, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

EULAR 2020 e-CONGRESS—Systemic rheumatic diseases can affect many organ systems; among the most important of these is the vascular system. Such conditions as atherosclerosis and venous thromboembolic disease can be influenced by inflammatory activity, and treatment of rheumatologic conditions may play a role in increasing or decreasing the risks of such diseases. At EULAR 2020, Zoltán Szekanecz, MD, PhD, professor and head of the rheumatology department at the University of Debrecen Medical and Health Sciences Center, Hungary, discussed these topics in a lecture titled, Arterial and Venous Risks and Management in Inflammatory Rheumatic Diseases.

You Might Also Like
  • Atherosclerosis, Cardiovascular Disease More Common in Patients with Primary Sjögren’s Syndrome
  • Psoriasis May Carry Atherosclerosis Risk Similar to that with Diabetes
  • Plasma Complement Activation in Rheumatic Diseases May Accelerate Coronary Artery Disease
Explore This Issue
October 2020
Also By This Author
  • String of Pearls: Lessons in Rheumatoid Arthritis

Dr. Szekanecz began by noting first and foremost that risk assessment of vascular disease should begin with patients’ traditional risk factors, such as family history, obesity, hypertension, diabetes mellitus, smoking and so forth. After these factors are considered, it’s important to look at the features of rheumatologic disease that may further increase the risks of such conditions as blood clots or coronary artery disease. It has been known for many years that rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) significantly enhance the risk of atherosclerotic cardiovascular disease. Recent work on these diseases indicates the primary contributor to the initiation and progression of atherosclerosis in RA and SLE is altered immune system function, with changes in cytokine levels and innate immune responses, autoantibodies, adipokines, dysfunctional lipids and oxidative stress playing a role.1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

In RA, biomarkers of inflammation can help predict the progression of atherosclerotic disease. Example: In an observational cohort study of 150 RA patients who underwent computed tomography angiography for evaluation of coronary atherosclerosis, 101 had repeat imaging within 5–10 years and time-averaged C-reactive protein (CRP) was a significant predictor of coronary artery plaque progression.2 Given this finding, several studies have looked at the effects of disease-modifying anti-rheumatic drugs (DMARDs) to protect against cardiovascular disease. Dr. Szekanecz cited several studies that indicate how methotrexate appears to have such protective effects among patients with RA and psoriatic arthritis.3-5 

This work has led to the hypothesis that methotrexate may be helpful for patients without rheumatologic conditions. However, a large, randomized, placebo-controlled clinical trial found low-dose methotrexate (15–20 mg weekly) did not reduce interleukin (IL) 1-β, IL-6, high sensitivity CRP or cardiovascular events more than placebo among patients with established coronary artery disease and either diabetes mellitus or metabolic syndrome, or both.6

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

With regard to biologic DMARDs, cross-sectional and retrospective analyses have shown that tumor necrosis factor inhibitor (TNFi) and non-TNF biologic use is associated with a low risk of arterial thromboembolic events and may be potentially helpful to patients without rheumatologic disease.

Pages: 1 2 3 4 | Single Page

Filed Under: Conditions Tagged With: atherosclerosis, EULAR, thrombosis, venous thromboembolismIssue: October 2020

You Might Also Like:
  • Atherosclerosis, Cardiovascular Disease More Common in Patients with Primary Sjögren’s Syndrome
  • Psoriasis May Carry Atherosclerosis Risk Similar to that with Diabetes
  • Plasma Complement Activation in Rheumatic Diseases May Accelerate Coronary Artery Disease
  • Intimacy & Rheumatic Conditions

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)