Cardio-rheumatology: present and future. Part II

Patients with rheumatic diseases exhibit a markedly increased risk of developing and accelerating cardiovascular pathology, which is largely attributed to the significant role of chronic inflammation as one of the etiological factors in both atherogenesis and heart failure. Achieving sustained clinical and laboratory remission of the Immune-mediated inflammatory disease has been shown to reduce the risk of cardiovascular complications. Given the direct association between persistent inflammation and a wide range of comorbid conditions, this factor must be carefully considered when planning and implementing rational pharmacotherapy in multimorbid patients. It is well established that pharmacological agents used in rheumatology exert diverse effects on the cardiovascular system. Over the past decade, growing research interest has been directed toward the potential application of anti-inflammatory agents with different mechanisms of action for both the prevention and treatment of atherosclerosis and ischemic heart disease. Particular attention has been paid to the modulation of the “NLRP3 inflammasome – interleukin-1 – interleukin-6 – C-reactive protein” signaling pathway. According to several studies, inhibition of this cascade may contribute to reduced likelihood of cardiovascular events. This review summarizes current data on the effects of various classes of antirheumatic drugs on the cardiovascular system, including both their beneficial and adverse effects.