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Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?

Evidence for increased risk of cardiovascular morbidity and mortality in chronic inflammatory rheumatic diseases has accumulated during the last years. Traditional cardiovascular risk factors contribute in part to the excess of cardiovascular risk in these patients and several mechanisms, including...

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Autores principales: Bartoloni, Elena, Alunno, Alessia, Valentini, Valentina, Luccioli, Filippo, Valentini, Eleonora, La Paglia, Giuliana Maria Concetta, Leone, Maria Comasia, Cafaro, Giacomo, Marcucci, Elisa, Gerli, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297850/
https://www.ncbi.nlm.nih.gov/pubmed/30619884
http://dx.doi.org/10.3389/fcvm.2018.00177
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author Bartoloni, Elena
Alunno, Alessia
Valentini, Valentina
Luccioli, Filippo
Valentini, Eleonora
La Paglia, Giuliana Maria Concetta
Leone, Maria Comasia
Cafaro, Giacomo
Marcucci, Elisa
Gerli, Roberto
author_facet Bartoloni, Elena
Alunno, Alessia
Valentini, Valentina
Luccioli, Filippo
Valentini, Eleonora
La Paglia, Giuliana Maria Concetta
Leone, Maria Comasia
Cafaro, Giacomo
Marcucci, Elisa
Gerli, Roberto
author_sort Bartoloni, Elena
collection PubMed
description Evidence for increased risk of cardiovascular morbidity and mortality in chronic inflammatory rheumatic diseases has accumulated during the last years. Traditional cardiovascular risk factors contribute in part to the excess of cardiovascular risk in these patients and several mechanisms, including precocious acceleration of subclinical atherosclerotic damage, inflammation, and immune system deregulation factors, have been demonstrated to strictly interplay in the induction and progression of atherosclerosis. In this setting, chronic inflammation is a cornerstone of rheumatic disease pathogenesis and exerts also a pivotal role in all stages of atherosclerotic damage. The strict link between inflammation and atherosclerosis suggests that cardiovascular risk may be reduced by rheumatic disease activity control. There are data to suggest that biologic therapies, in particular TNFα antagonists, may improve surrogate markers of cardiovascular disease and reduce CV adverse outcome. Thus, abrogation of inflammation is considered an important outcome for achieving not only control of rheumatic disease, but also reduction of cardiovascular risk. However, the actual effect of anti-rheumatic therapies on atherosclerosis progression and CV outcome in these patients is rather uncertain due to great literature inconsistency. In this paper, we will summarize some of the main mechanisms linking the inflammatory pathogenic background underlying rheumatic diseases and the vascular damage observed in these patients, with a particular emphasis on the pathways targeted by currently available therapies. Moreover, we will analyze current evidence on the potential atheroprotective effects of these treatments on cardiovascular outcome pointing out still unresolved questions.
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spelling pubmed-62978502019-01-07 Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality? Bartoloni, Elena Alunno, Alessia Valentini, Valentina Luccioli, Filippo Valentini, Eleonora La Paglia, Giuliana Maria Concetta Leone, Maria Comasia Cafaro, Giacomo Marcucci, Elisa Gerli, Roberto Front Cardiovasc Med Cardiovascular Medicine Evidence for increased risk of cardiovascular morbidity and mortality in chronic inflammatory rheumatic diseases has accumulated during the last years. Traditional cardiovascular risk factors contribute in part to the excess of cardiovascular risk in these patients and several mechanisms, including precocious acceleration of subclinical atherosclerotic damage, inflammation, and immune system deregulation factors, have been demonstrated to strictly interplay in the induction and progression of atherosclerosis. In this setting, chronic inflammation is a cornerstone of rheumatic disease pathogenesis and exerts also a pivotal role in all stages of atherosclerotic damage. The strict link between inflammation and atherosclerosis suggests that cardiovascular risk may be reduced by rheumatic disease activity control. There are data to suggest that biologic therapies, in particular TNFα antagonists, may improve surrogate markers of cardiovascular disease and reduce CV adverse outcome. Thus, abrogation of inflammation is considered an important outcome for achieving not only control of rheumatic disease, but also reduction of cardiovascular risk. However, the actual effect of anti-rheumatic therapies on atherosclerosis progression and CV outcome in these patients is rather uncertain due to great literature inconsistency. In this paper, we will summarize some of the main mechanisms linking the inflammatory pathogenic background underlying rheumatic diseases and the vascular damage observed in these patients, with a particular emphasis on the pathways targeted by currently available therapies. Moreover, we will analyze current evidence on the potential atheroprotective effects of these treatments on cardiovascular outcome pointing out still unresolved questions. Frontiers Media S.A. 2018-12-11 /pmc/articles/PMC6297850/ /pubmed/30619884 http://dx.doi.org/10.3389/fcvm.2018.00177 Text en Copyright © 2018 Bartoloni, Alunno, Valentini, Luccioli, Valentini, La Paglia, Leone, Cafaro, Marcucci and Gerli. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Bartoloni, Elena
Alunno, Alessia
Valentini, Valentina
Luccioli, Filippo
Valentini, Eleonora
La Paglia, Giuliana Maria Concetta
Leone, Maria Comasia
Cafaro, Giacomo
Marcucci, Elisa
Gerli, Roberto
Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title_full Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title_fullStr Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title_full_unstemmed Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title_short Targeting Inflammation to Prevent Cardiovascular Disease in Chronic Rheumatic Diseases: Myth or Reality?
title_sort targeting inflammation to prevent cardiovascular disease in chronic rheumatic diseases: myth or reality?
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297850/
https://www.ncbi.nlm.nih.gov/pubmed/30619884
http://dx.doi.org/10.3389/fcvm.2018.00177
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