Atherosclerotic Cardiovascular Risk Stratification in the Rheumatic Diseases:: An Integrative, Multiparametric Approach

Rheum Dis Clin North Am. 2023 Feb;49(1):19-43. doi: 10.1016/j.rdc.2022.07.004.

Abstract

Cardiovascular disease (CVD) risk is increased in most inflammatory rheumatic diseases (IRDs), reiterating the role of inflammation in the initiation and progression of atherosclerosis. An inverse association of CVD risk with body weight and lipid levels has been described in IRDs. Coronary artery calcium scores, plaque burden and characteristics, and carotid plaques on ultrasound optimize CVD risk estimate in IRDs. Biomarkers of cardiac injury, autoantibodies, lipid biomarkers, and cytokines also improve risk assessment in IRDs. Machine learning and deep learning algorithms for phenotype and image analysis hold promise to improve CVD risk stratification in IRDs.

Keywords: Ankylosing spondylitis; Cardiovascular risk factors; Cardiovascular risk score; Psoriatic arthritis; Rheumatoid arthritis; Systemic lupus erythematosus.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Atherosclerosis* / etiology
  • Biomarkers
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Humans
  • Lipids
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Rheumatic Diseases* / complications
  • Risk Factors

Substances

  • Biomarkers
  • Lipids