Enhancing Cardiovascular Risk Prediction for Better Management in Rheumatic Diseases

Rawn Salenger^*
*Correspondence: Rawn Salenger, Department of Surgery, UM St Joseph Medical Center, 7505 Osler Dr, Ste 302, Towson, MD 21204, USA, Email:

Introduction

Rheumatic diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis, are associated with an increased risk of cardiovascular disease. This heightened risk stems from a combination of chronic inflammation, autoimmune dysfunction, and traditional CVD risk factors. Enhancing cardiovascular risk prediction in individuals with rheumatic diseases is crucial for better management and improved outcomes [1].

Traditional cardiovascular risk assessment tools, such as the Framingham Risk Score or the American College of Cardiology/American Heart Association cardiovascular risk calculator, may underestimate risk in patients with rheumatic diseases. Including disease-specific biomarkers, such as anti-cyclic citrullinated peptide antibodies in RA or anti-double-stranded DNA antibodies in SLE can help refine risk prediction models. Advanced imaging techniques, such as coronary artery calcium scoring by computed tomography and carotid ultrasound, can detect subclinical atherosclerosis in patients with rheumatic diseases. Integrating these modalities into risk assessment algorithms provides additional information beyond traditional risk factors. Chronic inflammation plays a central role in the pathogenesis of rheumatic diseases and contributes to accelerated atherosclerosis. Monitoring inflammatory markers, such as C-reactive protein and erythrocyte sedimentation rate can aid in risk stratification and guide treatment decisions [2-4].

Description

Endothelial dysfunction precedes the development of overt atherosclerosis and is prevalent in rheumatic diseases. Non-invasive techniques, such as flow-mediated dilation or peripheral arterial tonometry can assess endothelial function and predict cardiovascular risk in these patients. Developing multimodal risk scores that integrate traditional cardiovascular risk factors with disease-specific parameters and biomarkers can enhance risk prediction accuracy in rheumatic diseases. These scores should be validated in diverse patient populations to ensure generalizability. Engage patients in shared decision-making regarding cardiovascular risk assessment and management. Educate them about their increased cardiovascular risk and the importance of lifestyle modifications, including smoking cessation, regular exercise, and a heart-healthy diet [5].

Conclusion

Individualize preventive strategies based on the patient's overall cardiovascular risk profile, disease activity, and treatment regimen. Consider aggressive lipid-lowering therapy, antiplatelet agents, and targeted anti-inflammatory treatments to mitigate cardiovascular risk in high-risk patients with rheumatic diseases. Foster interdisciplinary collaboration between rheumatologists, cardiologists, and primary care physicians to optimize cardiovascular risk assessment and management in patients with rheumatic diseases. Shared care models facilitate comprehensive evaluation and coordinated interventions. Enhancing cardiovascular risk prediction in rheumatic diseases requires a multifaceted approach that acknowledges the complex interplay between inflammation, autoimmunity, and traditional cardiovascular risk factors. By incorporating disease-specific biomarkers, advanced imaging techniques, and inflammatory markers into risk assessment algorithms, healthcare providers can identify high-risk patients early and implement personalized preventive strategies to mitigate cardiovascular morbidity and mortality in this vulnerable population.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Makavos, George, Maria Varoudi, Konstantina Papangelopoulou and Eirini Kapniari, et al. "Echocardiography in autoimmune rheumatic diseases for diagnosis and prognosis of cardiovascular complications." Medicina 56 (2020): 445.

Google Scholar, Crossref, Indexed at

2. Symmons, Deborah PM and Sherine E. Gabriel. "Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE." Nature Rev Rheumatol 7 (2011): 399-408.

Google Scholar, Crossref, Indexed at

3. Villa-Forte, Alexandra and Brian F. Mandell. "Cardiovascular disorders and rheumatic disease." Spanish J Cardiol 64 (2011): 809-817.

Google Scholar, Crossref, Indexed at

4. Owlia, Mohammad Bagher, Seyed Mohammad Yousof Mostafavi Pour Manshadi and Nafiseh Naderi. "Cardiac manifestations of rheumatological conditions: A narrative review." Int Scholar Res Notices 2012 (2012).

Google Scholar, Crossref, Indexed at

5. Buleu, Florina, Elena Sirbu, Alexandru Caraba and Simona Dragan. "Heart involvement in inflammatory rheumatic diseases: A systematic literature review." Medicina 55 (2019): 249.

Google Scholar, Crossref, Indexed at