Cardiovascular risk in patients with rheumatic disease and its management

Česká verzia

Authors: Jiří Laštůvka ¹; Sabína Oreská ²; Michal Tomčík ²; Michal Vrablík ³
Authors place of work: Interní oddělení Masarykovy nemocnice v Ústí nad Labem, o. z., Krajská zdravotní a. s. ¹; Revmatologický ústav a Revmatologická klinika 1. LF UK a VFN v Praze ²; III. interní klinika – klinika endokrinologie a metabolizmu 1. LF UK a VFN v Praze ³
Published in the journal: Vnitř Lék 2018; 64(1): 51-59
Category: Reviews

Summary

Cardiovascular disease (CVD) risk in patients with rheumatic diseases is increased by 50 % compared to the general population. This is a result of the increased inflammatory activity as well as modification of traditional CVD risk factors by the primary disease. So called lipid paradox, paradoxical decrease of concentrations of atherogenic plasma lipids due to increased inflammatory activity and their rise with successful anti-inflammatory treatment, is of particular importance. CVD risk in rheumatic diseases is further modified by drugs used for their treatment: while some treatment modalities increase the risk (e.g. glucocorticoids), others may act in an opposite direction (methotrexate, biological therapies). CVD risk stratification in patients with rheumatic diseases is uneasy; so far none of the specific scoring systems has been shown superior to traditional ones designed for the general population. Principles of cardiovascular risk intervention remain the same as for the general population: the management starts with lifestyle measures (healthy diet, increase in physical activity and smoking cessation) complemented with pharmacotherapy when indicated. Blood pressure as well as lipid lowering therapies should be led according to the same principles as in the general population and, also, to the same treatment goals. To improve CVD prevention outcomes in patients with rheumatic diseases it seems feasible to work in interdisciplinary teams led by a rheumatologist cooperating with a specialist in CVD prevention strategies (general practitioner, cardiologist, internist, diabetes specialist). A nutritional therapist and a physiotherapist are important members of the team, too. Interdisciplinary and complex CVD prevention in patients with rheumatic diseases decreases CVD morbidity.

Key words:
cardiovascular risk – intervention – lipid paradox – rheumatic diseases – risk factors – risk stratification

Zdroje

1. Dadoun S, Zeboulon-Ktorza N, Combescure C et al. Mortality in rheumatoid arthritis over the last fifty years: systematic review and meta-analysis. Joint Bone Spine 2013; 80(1): 29–33. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jbspin.2012.02.005>.

2. Wolfe F, Mitchell DM, Sibley JT et al. The mortality of rheumatoid arthritis. Arthritis Rheum 1994; 37(4): 481–494.

3. Aviña-Zubieta J, Choi H, Sadatsafavi M et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 2008; 59(12): 1690–1697. Dostupné z DOI: <http://dx.doi.org/10.1002/art.24092>.

4. Gabriel SE. Cardiovascular morbidity and mortality in rheumatoid arthritis. Am J Med 2008; 121(10 Suppl 1): S9-S14. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2008.06.011>.

5. van Halm VP, Peters MJL, Voskuyl AE et al. Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation. Ann Rheum Dis 2009; 68(9): 1395–1400. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2008.094151>.

6. Lindhardsen J, Ahlerhof O, GislasonGH et al. The risk of myocardial infarction in rheumatoid arthritis and diabetes mellitus: a Danish nationwide cohort study. Ann Rheum Dis 2011; 70(6): 929–934. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2010.143396>.

7. Bakland G, Gran JT, Nossent JC. Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis 2011; 70(11): 1921–1925. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2011.151191>.

8. Agca R, Heslinga SC, Rollefstad S et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 2017; 76(1): 17–28. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2016–209775>.

9. Yusuf S, Hawken S, Ôunpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364(9438): 937–952. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(04)17018–9>.

10. Gonzalez A, Maradit Kremers H, Crowson CS et al. Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients? Ann Rheum Dis 2008; 67(1): 64–69. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2006.059980>.

11. Rojas-Serrano J, Perez L, Garcia C et al. Current smoking status is associated to a non-ACR 50 response in early rheumatoid arthritis. A cohort study. Clin Rheumatol 2011; 30(12): 1589–1593. Dostupné z DOI: <http://dx.doi.org/10.1007/s10067–011–1775–5>.

12. Boyer JF, Gourraud PA, Cantagrel A et al. Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine 2011; 78(2): 179–183. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jbspin.2010.07.016>.

13. Rho YH, Oeser A, Chung CP et al. Drugs Used in the Treatment of Rheumatoid Arthritis: Relationship between Current Use and Cardiovascular Risk Factors. Arch Drug Inf 2009; 2(2): 34–40. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1753–5174.2009.00019.x>.

14. Abou Assi H, Connelly MA, Bateman LA et al. Does a lack of physical activity explain the rheumatoid arthritis lipid profile? Lipids Health Dis 2017; 16(1): 39. Dostupné z DOI: <http://dx.doi.org/10.1186/s12944–017–0427–4>.

15. Ursini F, Russo E, D’Angelo S et al. Prevalence of Undiagnosed Diabetes in Rheumatoid Arthritis: an OGTT Study. Medicine (Baltimore) 2016; 95(7): e2552. Dostupné z DOI: <http://dx.doi.org/10.1097/MD.0000000000002552>.

16. Lu MC, Yan ST, Yin WY et al. Risk of Rheumatoid Arthritis in Patients with Type 2 Diabetes: A Nationwide Population-Based Case-Control Study. PLOS ONE 2014; 9(7): e101528. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0101528>.

17. Stavropoulos-Kalinoglou A, Metsios G, Koutedakis Y et al. Obesity in rheumatoid arthritis. Rheumatology (Oxford) 2011; 50(3): 450–462. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/keq266>.

18. Cooney, JK Law RJ, Matshke V et al. Benefits of Exercise in Rheumatoid Arthritis. J Aging Res 2011; 2011: 681640. Dostupné z DOI: <http://dx.doi.org/10.4061/2011/681640>.

19. Solomon A, Woodiwiss A., Abdool-Carrim A et al. The carotid artery atherosclerosis burden and its relation to cardiovascular risk factors in black and white Africans with established rheumatoid arthritis: a cross-sectional study. J Rheumatol 2012; 39(9): 1798–1806. Dostupné z DOI: <http://doi: 10.3899/jrheum.120073>.

20. O‘Neill F, Riwanto M, Charakida M et al. Structural and functional changes in HDL with low grade and chronic inflammation. Int J Cardiol 2015; 188: 111–116. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ijcard.2015.03.058>.

21. von Eckardstein A, Widmann C. High-density lipoprotein, beta cells, and diabetes. Cardiovasc Res 2014; 103(3): 384–394. Dostupné z DOI: <http://dx.doi.org/10.1093/cvr/cvu143>.

22. Choy E, Ganeshalingam K, Semb AG et al. Cardiovascular risk in rheumatoid arthritis: recent advances in the understanding of the pivotal role of inflammation, risk predictors and the impact of treatment. Rheumatology 2014; 53(12), 2143–2154. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/keu224>.

23. Rho YH, Chung CP, Oeser A et al. Inflammatory Mediators and Premature Coronary Atherosclerosis in Rheumatoid Arthritis. Arthritis Rheum 2009; 61(11): 1580–1585. Dostupné z DOI: <http://dx.doi.org/10.1002/art.25009>.

24. Ridker PM, MacFadyen JG, Everett BM et al. [CANTOS Trial Group]. Relationship of C-reactive protein reduction to cardiovascular event reduction following treatment with canakinumab: a secondary analysis from the CANTOS randomised controlled trial. Lancet. 2017. pii: S0140–6736(17)32814–3. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(17)32814–3>.

25. Godson NJ, Wiles NJ, Lunt M et al. Mortality in early inflammatory polyarthritis: cardiovascular mortality is increased in seropositive patients. Arthritis Rheum 2002; 46(8): 2010–2019. Dostupné z DOI: <http://dx.doi.org/10.1002/art.10419>.

26. Pepine CJ, Gurbel PA. Cardiovascular safety of NSAIDs: Additional insights after PRECISION and point of view. Clin Cardiol 2017. Dostupné z DOI: <http://dx.doi.org/10.1002/clc.22814>.

27. W J, Bijlsma J, Buttgereit F. Adverse events of glucocorticoids during treatment of rheumatoid arthritis: lessons from cohort and registry studies. Rheumatology (Oxford) 2016; 55(Suppl 2): ii3-ii5. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/kew344>.

28. Micha R, Imamura F, Wyler von Ballmoos M et al. Systematic review and meta-analysis of methotrexate use and risk of cardiovascular disease. Am J Cardiol 2011; 108(9): 1362–1370. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2011.06.054>.

29. Ramiro S, Sepriano A, Chatzidionysiou K et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis 2017; 76(6): 1101–1136. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2016–210708>.

30. Roubille C, Richer V, Starnino T et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis 2015; 74(3): 480–489. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2014–206624>.

31. Goodson N, Brookhart A, Symmons D et al. Non-steroidal anti-inflammatory drug use does not appear to be associated with increased cardiovascular mortality in patients with inflammatory polyarthritis: results from a primary care based inception cohort of patients. Ann Rheum Dis 2009; 68(3): 367–372. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2007.076760>.

32. Lindhardsen J, Gislason G, Jacobsen S et al. Non-steroidal anti-inflammatory drugs and risk of cardiovascular disease in patients with rheumatoid arthritis: a nationwide cohort study. Ann Rheum Dis 2013; 73(8): 1515–1521. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2012–203137>.

33. Kearney PM, Baigent C, Goodwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ 2006; 332(7553): 1302–1308. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.332.7553.1302>.

34. Fardet L, Fève B. Systemic glucocorticoid therapy: a review of its metabolic and cardiovascular adverse events. Drugs 2014; 74(15): 1731–1745. Dostupné z DOI: <http://dx.doi.org/10.1007/s40265–014–0282–9>.

35. Avina-Zubieta J, Abrahamowicz M, De Vera M et al. Immediate and past cumulative effects of oral glucocorticoids on the risk of acute myocardial infarction in rheumatoid arthritis: a population-based study. Rheumatology (Oxford) 2013; 52(1): 68–75. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/kes353>.

36. Naranjo A, Sokka T, Descalzo M et al. Cardiovascular disease in patients with rheumatoid arthritis: results from the Quest-RA study. Arthritis Res Ther 2008; 10(2): R30. Dostupné z DOI: <http://dx.doi.org/10.1186/ar2383>.

37. Landewe RB, van den Borne BE, Breedveld FC et al. Methotrexate effects in patients with rheumatoid arthritis with cardiovascular comorbidity. Lancet 2000; 355(9215): 1616–1617. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(00)02222–4>.

38. Choi HK, Hernan MA, Seeger JD et al. Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 2002; 359(9313): 1173–1177. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(02)08213–2>.

39. Micha R, Imamura F, von Ballmoos MW et al. Systematic review and meta-analysis of methotrexate use and risk of cardiovascular disease. Am J Cardiol 2011; 108(9): 1362–1370. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2011.06.054>.

40. Clarke R, Halsey J, Lewington S et al. [B-Vitamin Treatment Trialists‘ Collaboration]. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med 2010; 170(18): 1622–1631. Dostupné z DOI: <http://dx.doi.org/10.1001/archinternmed.2010.348>.

41. Ridker PM. Testing the inflammatory hypothesis of atherothrombosis: scientific rationale for the cardiovascular inflammation reduction trial (CIRT). J Thromb Haemost 2009; 7(Suppl 1): 332–339. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1538–7836.2009.03404.x>.

42. Wasko MC, Hubert HB, Lingala VB et al. Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis. JAMA 2007; 298(2): 187–193. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.298.2.187>.

43. Atzeni F, Turiel M, Caporali R et al. The effect of pharmacological therapy on the cardiovascular system of patients with systemic rheumatic diseases. Autoimmun Rev 2010; 9(12): 835–839. Dostupné z DOI: <http://dx.doi.org/10.1016/j.autrev.2010.07.018>.

44. Dixon WG, Watson KD, Lunt M et al. Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: Biologics Register. Arthritis Rheum 2007; 56(9): 2905–2912. Dostupné z DOI: <http://dx.doi.org/10.1002/art.22809>.

45. Jacobsson LT, Turesson C, Gulfe A et al. Treatment with tumor necrosis factor blockers is associated with a lower incidence of first cardiovascular events in patients with rheumatoid arthritis. J Rheumatol 2005; 32(7): 1213–1218.

46. Angel K, Provan SA, Fagerhol MK et al. Effect of 1-year anti-TNF-alpha therapy on aortic stiffness, carotid atherosclerosis, and calprotectin in inflammatory arthropathies: a controlled study. Am J Hypertens 2012; 25(6): 644–650. Dostupné z DOI: <http://dx.doi.org/10.1038/ajh.2012.12>.

47. Ljung L, Simard JF, Jacobsson L et al. Treatment with tumor necrosis factor inhibitors and the risk of acute coronary syndromes in early rheumatoid arthritis. Arthritis Rheum 2012; 64(1): 42–52. Dostupné z DOI: <http://dx.doi.org/10.1002/art.30654>.

48. Naerr GW, Rein P, Saely CH et al. Effects of synthetic and biological disease modifying antirheumatic drugs on lipid and lipoprotein parameters in patients with rheumatoid arthritis. Vascul Pharmacol 2016; 81: 22–30. Dostupné z DOI: <http://dx.doi.org/10.1016/j.vph.2016.01.006>.

49. Olejárová M. Nežádoucí účinky biologické léčby v revmatologii. Vnitř Lék 2016; 62(7–8): 605–612.

50. Winer DA, Winer S, Shen L et al. B Lymphocytes Promote Insulin Resistance through Modulation of T Lymphocytes and Production of Pathogenic IgG Antibody. Nat Med 2011; 17(5): 610–617. Dostupné z DOI: <http://dx.doi.org/10.1038/nm.2353>.

51. Novikova DS, Popkova TV, Lukina GV et al. The Effects of Rituximab on Lipids, Arterial Stiffness and Carotid Intima-Media Thickness in Rheumatoid Arthritis. J Korean Med Sci 2016; 31(2): 202–207. Dostupné z DOI: <http://dx.doi.org/10.3346/jkms.2016.31.2.202>.

52. McInnes IB, Kim HY, Lee SH et al. Open-label tofacitinib and double-blind atorvastatin in rheumatoid arthritis patients: a randomised study. Ann Rheum Dis 2014; 73(1): 124–131. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2012–202442>.

53. Bartels C, Kind A, Everett C et al. Low frequency of primary lipid screening among medicare patients with rheumatoid arthritis. Arthritis Rheum 2011; 63(5): 1221–1230. Dostupné z DOI: <http://dx.doi.org/10.1002/art.30239>.

54. Ikdahl E, Rollefstad S, Wibetoe G et al. Exploring The Inadequate Cardiovascular Disease Prevention in Inflammatory Joint Diseases: Results from The NOCAR Project. Ann Rheum Dis 2016; 75(Suppl 2): 473.

55. Chung CP, Giles JT, Petri M et al. Prevalence of traditional cardiovascular risk factors in patients with rheumatoid arthritis: comparison with control subjects from multi-ethnic study of atherosclerosis. Semin Arthritis Rheum 2012; 41(4): 535–544. Dostupné z DOI: <http://dx.doi.org/10.1016/j.semarthrit.2011.07.004>.

56. Crowson CS, Matteson EL, Roger VL et al Usefulness of risk scores to estimate the risk of cardiovascular disease in patients with rheumatoid arthritis. Am J Cardiol 2012; 110(3): 420–424. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2012.03.044>.

57. Arts EE, Popa CD, den Broeder AA et al. Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms. Ann Rheum Dis 2016; 75(4): 674–680. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2014–206879>.

58. Wiersma T, Smulders YM, Stehouwer CD et al. Summary of the multidisciplinary guideline on cardiovascular risk management (revision 2011). Ned Tijdschr Geneeskd 2012; 156(36): A5104.

59. Arts EEA, Popa C, Broeder AA et al. Performance of four current risk algorithms in predicting cardiovascular events in patients with early rheumatoid arthritis. Ann Rheum Dis 2015; 74(4): 668–674. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2013–204024>.

60. Solomon DH, Greenberg J, Curtis JR et al. Derivation and internal validation of an expanded cardiovascular risk prediction score for rheumatoid arthritis: a Consortium of Rheumatology Researchers of North America Registry Study. Arthritis Rheumatol 2015; 67(8): 1995–2003. Dostupné z DOI: <http://dx.doi.org/10.1002/art.39195>. Erratum in Errata. [Arthritis Rheumatol. 2016].

61. Arts E. OP0164 A Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis (ATACC-RA). EULAR 2014: Scientific Abstracts Oral Presentations. Abstract session: Comorbidity and disease impact in RA. Ann Rheum 2014; 73(suppl 2): S123-S124. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2014-eular.1712>.

62. Crowson CS, Rollefstad S, Kitas GD et al. [A Trans-Atlantic Cardiovascular Risk Consortium for Rheumatoid Arthritis (ATACC-RA)]. Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis. PLoS One 2017; 12(3): e0174656. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0174656>. Erratum in Correction: Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis. [PLoS One 2017].

63. Ford ES. Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology 2002; 13(5): 561–568. Dostupné z DOI: <http://dx.doi.org/10.1097/01.EDE.0000023965.92535.C0>.

64. Cooney JK, Law RJ, Matshke V. Benefits of Exercise in Rheumatoid Arthritis. J Aging Res 2011; 2011: 681640. Dostupné z DOI: <http://dx.doi.org/10.4061/2011/681640>.

65. Vrablík M. Farmakoterapie dyslipidemie: průvodce ošetřujícího lékaře. 2. vyd. Maxdorf Jessenius: Praha 2016. ISBN 978–80–7345–503–3.

66. Pella D, Gvozdjáková A, Lietava J et al. Myopatie asociovaná se statiny: klinické doporučení Slovenskej asociácie aterosklerózy a České společnosti pro aterosklerózu. AtheroRev 2016, 1(1): 7–13.

67. Kitas G, Nightingale P, Armitage J et al. SAT0105 Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients with Rheumatoid Arthritis (TRACE RA). 2015 ACR/ARHP Annual Meeting. Arthritis Rheumatol. 2015; 67(Suppl 10). Dostupné z WWW: <http://acrabstracts.org/abstract/trial-of-atorvastatin-for-the-primary-prevention-of-cardiovascular-events-in-patients-with-rheumatoid-arthritis/>.

68. McCarey DW, McInnes IB, Madhok R et al. Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebo-controlled trial. Lancet 2004; 363(9426): 2015–2021. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(04)16449–0>.

69. Semb AG, Kvien TK, DeMicco DA et al. Effect of intensive lipid-lowering therapy on cardiovascular outcome in patients with and those without inflammatory joint disease. Arthritis Rheum 2012; 64(9): 2836–2846. Dostupné z DOI: <http://dx.doi.org/10.1002/art.34524>.

70. Hollan I, Dessein PH, Ronda N et al. Prevention of cardiovascular disease in rheumatoid arthritis. Autoimmun Rev 2015; 14(10): 952–969. Dostupné z DOI: <http://dx.doi.org/10.1016/j.autrev.2015.06.004>.