TY - JOUR
T1 - Genetic relationship between rheumatoid arthritis and cardiovascular diseases
T2 - A systematic review of Mendelian randomization studies
AU - Ausserwinkler, Mathias
AU - Gensluckner, Sophie
AU - Voelkerer, Andreas
AU - Thiel, Jens
AU - Neumann, Hans-Joerg
AU - Flamm, Maria
AU - Datz, Christian
AU - Aigner, Elmar
AU - Wernly, Bernhard
N1 - Ausserwinkler, Gensluckner, Aigner: First Department of Medicine, University Clinic Salzburg, Paracelsus Medical University, Salzburg, Austria; Wernly Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus MedicalUniversity Salzburg, Salzburg, Austria; Flamm, Wernly: nstitute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University,
Strubergasse 21, 5020 Salzburg, Austria
PY - 2024/7/26
Y1 - 2024/7/26
N2 - ObjectiveRheumatoid arthritis (RA) is recognized as a chronic autoimmune disorder with systemic inflammation and joint damage. Its potential role as a risk factor for cardiovascular diseases (CVD) is increasingly noted. This review delves into the causal relationship between RA and CVD, with Mendelian randomization (MR) offering a genetic perspective.MethodsAn extensive search was conducted in PubMed, Cochrane and Web of Science to identify MR studies addressing the RA-CVD link. Out of 530 studies, 9 met the inclusion criteria, which were rigorously assessed using a critical appraisal checklist. These were further stratified by a sensitivity analysis into categories reflecting the strength of their evidence, from not evaluable to robust.ResultsFrom the nine included studies, eight supported a causal association between RA and an increased risk of CVD, specifically coronary artery disease (CAD) and one did not support a link between RA and heart failure. The results suggest that genetic factors associated with RA may contribute to an elevated risk for CVD. Chronic inflammation, prevalent in RA, emerges as a key mediator in this connection.ConclusionThe systematic review corroborates a genetic causal link between RA and CVD, as evidenced by eight of the nine MR studies reviewed. This suggests a need for integrated cardiovascular risk management in the treatment of RA patients. The findings advocate considering anti-inflammatory treatment that can reduce cardiovascular risk. The overarching evidence signifies a potential direction for new therapeutic strategies aimed at enhancing cardiovascular health in RA patients.
AB - ObjectiveRheumatoid arthritis (RA) is recognized as a chronic autoimmune disorder with systemic inflammation and joint damage. Its potential role as a risk factor for cardiovascular diseases (CVD) is increasingly noted. This review delves into the causal relationship between RA and CVD, with Mendelian randomization (MR) offering a genetic perspective.MethodsAn extensive search was conducted in PubMed, Cochrane and Web of Science to identify MR studies addressing the RA-CVD link. Out of 530 studies, 9 met the inclusion criteria, which were rigorously assessed using a critical appraisal checklist. These were further stratified by a sensitivity analysis into categories reflecting the strength of their evidence, from not evaluable to robust.ResultsFrom the nine included studies, eight supported a causal association between RA and an increased risk of CVD, specifically coronary artery disease (CAD) and one did not support a link between RA and heart failure. The results suggest that genetic factors associated with RA may contribute to an elevated risk for CVD. Chronic inflammation, prevalent in RA, emerges as a key mediator in this connection.ConclusionThe systematic review corroborates a genetic causal link between RA and CVD, as evidenced by eight of the nine MR studies reviewed. This suggests a need for integrated cardiovascular risk management in the treatment of RA patients. The findings advocate considering anti-inflammatory treatment that can reduce cardiovascular risk. The overarching evidence signifies a potential direction for new therapeutic strategies aimed at enhancing cardiovascular health in RA patients.
KW - Cardiovascular diseases
KW - Chronic inflammation
KW - Genetic causality
KW - Inflammatory joint disease
KW - Mendelian randomization
KW - Rheumatoid arthritis
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001276945600001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s00508-024-02392-8
DO - 10.1007/s00508-024-02392-8
M3 - Review article
C2 - 39060548
SN - 0043-5325
JO - WIENER KLINISCHE WOCHENSCHRIFT
JF - WIENER KLINISCHE WOCHENSCHRIFT
ER -