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Semin Thromb Hemost 2010; 36(4): 452-457
DOI: 10.1055/s-0030-1254054
© Thieme Medical Publishers

The Prothrombotic State in Rheumatoid Arthritis: An Additive Risk Factor for Adverse Cardiovascular Events

Radjesh J. Bisoendial1 , Marcel Levi2 , Paul-Peter Tak1 , Eric S. G Stroes3
  • 1Department of Clinical Immunology and Rheumatology, University of Amsterdam, The Netherlands
  • 2Department of Internal Medicine, University of Amsterdam, The Netherlands
  • 3Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
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Publication History

Publication Date:
07 July 2010 (online)

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ABSTRACT

Rheumatoid arthritis (RA) has been recognized to increase cardiovascular morbidity and mortality independent of established risk factors. The chronic inflammatory state, a hallmark of RA, is considered an autonomous risk factor, whereas components of innate and adaptive immunity are believed to contribute to the onset of acute cardiovascular events. Several studies have suggested that RA confers a prothrombotic state featured by abnormalities in coagulation and fibrinolytic systems together with an altered state of platelet reactivity. It is conceivable that these findings may be partly instrumental for the observed increased risk for adverse cardiovascular events in RA. Therapeutic strategies aimed at attenuating the inflammatory disease activity and intervening at the point of cross-talk between mediators of inflammation and thrombogenesis may help reduce cardiovascular disease burden in patients with RA.

KEYWORDS

Rheumatoid arthritis - atherosclerosis - thrombosis - inflammation

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Radjesh BisoendialM.D. Ph.D. 

Department Internal Medicine (F-4), Academic Medical Center

University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Email: r.j.bisoendial@amc.uva.nl