Atherosclerosis in Rheumatoid Arthritis: Promoters and Opponents

Federico Carbone, Aldo Bonaventura, Luca Liberale, Sabrina Paolino, Francesco Torre, Franco Dallegri, Fabrizio Montecucco, Maurizio Cutolo

Research output: Contribution to journalReview articlepeer-review


Substantial epidemiological data identified cardiovascular (CV) diseases as a main cause of mortality in patients with rheumatoid arthritis (RA). In light of this, RA patients may benefit from additional CV risk screening and more intensive prevention strategies. Nevertheless, current algorithms for CV risk stratification still remain tailored on general population and are burdened by a significant underestimation of CV risk in RA patients. Acute CV events in patients with RA are largely related to an accelerated atherosclerosis. As pathophysiological features of atherosclerosis overlap those occurring in the inflamed RA synovium, the understanding of those common pathways represents an urgent need and a leading challenge for CV prevention in patients with RA. Genetic background, metabolic status, gut microbiome, and systemic inflammation have been also suggested as additional key pro-atherosclerotic factors. The aim of this narrative review is to update the current knowledge about pathophysiology of atherogenesis in RA patients and potential anti-atherosclerotic effects of disease-modifying anti-rheumatic drugs.

Original languageEnglish
JournalClinical Reviews in Allergy and Immunology
Issue number1
Publication statusPublished - Feb 1 2020


  • Adipocytokines
  • Atherosclerosis
  • Microbiome
  • Neutrophil extracellular traps
  • Rheumatoid arthritis
  • Single nucleotide polymorphisms

ASJC Scopus subject areas

  • Immunology and Allergy

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