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Assessment of cardiovascular risk with C-reactive protein in rheumatoid arthritis patients

Published:August 13, 2022DOI:https://doi.org/10.1016/j.ejim.2022.08.010
      Over the past decades, it has become increasingly accepted that the risk of cardiovascular (CV) morbidity and mortality is noticeably augmented in rheumatoid arthritis (RA) patients [
      • Hansildaar R.
      • Vedder D.
      • Baniaaman M.
      • et al.
      Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout.
      ]. When compared to the general population, the mere existence of said condition increases CV death risk by up to 50% [
      • Choy E.
      • Ganeshalingam K.
      • Semb A.G.
      • 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.
      ]. Furthermore, more than half of premature mortality in these patients is attributable to CV disease, which remains as their leading cause of death [
      • Choy E.
      • Ganeshalingam K.
      • Semb A.G.
      • 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.
      ,
      • Solomon D.H.
      • Greenberg J.
      • Curtis J.R.
      • 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.
      ,
      • Pope J.E.
      • Choy E.H.
      C-reactive protein and implications in rheumatoid arthritis and associated comorbidities.
      ]. Therefore, RA, by itself, is now accepted as an independent cardiovascular risk factor, due to its inherent chronic and systemic pro-inflammatory state [
      • Hansildaar R.
      • Vedder D.
      • Baniaaman M.
      • et al.
      Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout.
      ]. Nonetheless, traditional risk factors (e.g., the presence of diabetes, hypertension or hyperlipidaemia) remain important, as they also account for a steep increase in CV illness odds [
      • Hansildaar R.
      • Vedder D.
      • Baniaaman M.
      • et al.
      Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout.
      ].
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