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The cardiovascular risk factors in patients with rheumatoid arthritis (RA) are reviewed. The perspectives of treatments with statins in RA are given. Results of clinical trials on statin effects on the inflammatory disease activity and endothelial function in patients with RA are summarized.

About the Authors

D. A. Anichkov
Russian State Medical University, Moscow
Russian Federation
Nesterov Department of Faculty Therapy

N. A. Shostak
Russian State Medical University, Moscow
Russian Federation
Nesterov Department of Faculty Therapy


1. Аронов Д.М. Каскад терапевтических эффектов статинов. Кардиология 2004;44(10):85-94.

2. Грацианский Н.А. Статины как противовоспалительные средства. Кардиология 2001;41(12):14-26.

3. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации. Кардиоваск тер профилакт 2004;2(приложение):1-36.

4. Насонов Е.Л, Панюкова Е.В, Александрова Е.Н. С-реактивный белок – маркер воспаления при атеросклерозе (новые данные). Кардиология 2002;42(7):53-62.

5. Насонов Е.Л. Проблема атеротромбоза в ревматологии. Вестн Росс акад мед наук 2003;(7):6-10.

6. Abud-Mendoza C, de la Fuente H, Cuevas-Orta E, et al. Therapy with statins in patients with refractory rheumatic diseases: a preliminary study. Lupus. 2003;12(8):607-611.

7. Ahmad S. Lovastatin-induced lupus erythematosus. Arch Intern Med. 1991;151(8):1667-1668.

8. Albano SA, Santana-Sahagun E, Weisman MH. Cigarette smoking and rheumatoid arthritis. Semin Arthritis Rheum. 2001;31(3):146-59.

9. Barsante MM, Roffe E, Yokoro CM, et al. Anti-inflammatory and analgesic effects of atorvastatin in a rat model of adjuvant-induced arthritis. Eur J Pharmacol. 2005;516(3):282-9.

10. Bergholm R, Leirisalo-Repo M, Vehkavaara S, et al. Impaired responsiveness to NO in newly diagnosed patients with rheumatoid arthritis. Arterioscler Thromb Vasc Biol 2002;22: 1637-41.

11. Boers M, Nurmohamed MT, Doelman CJ, et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis. 2003;62(9):842-5.

12. Book C, Saxne T, Jacobsson LT. Prediction of mortality in rheumatoid arthritis based on disease activity markers. J Rheumatol. 2005;32(3):430-4.

13. Chung CP, Oeser A, Raggi P, et al. Increased coronary-artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors. Arthritis Rheum. 2005;52(10):3045-53.

14. Conroy RM, Pyorala K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24:987-1003.

15. del Rincon I, Williams K, Stern MP, et al. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 2001;44:2737-2745.

16. del Rincon I, Escalante A. Atherosclerotic cardiovascular disease in rheumatoid arthritis. Curr Rheumatol Rep. 2003;5(4):278-86.

17. Escalante A, Haas RW, del Rincon I. Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med. 2005;165(14):1624-9.

18. Fenton JW 2nd, Jeske WP, Catalfamo JL, et al. Statin drugs and dietary isoprenoids downregulate protein prenylation in signal transduction and are antithrombotic and prothrombolytic agents. Bio￾chemistry (Mosc) 2002;67:85-91.

19. Gabriel SE, Crowson CS, Kremers HM, et al. Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years. Arthritis Rheum. 2003;48(1):54-8.

20. Garcia PJ. Pleiotropic effects of statins: moving beyond cholesterol control. Curr Atheroscler Rep. 2005;7(1):34-39.

21. Gerli R, Sherer Y, Vaudo G, et al. Early atherosclerosis in rheumatoid arthritis: effects of smoking on thickness of the carotid artery intima media. Ann N Y Acad Sci. 2005;1051:281-90.

22. Goodson NJ, Wiles NJ, Lunt M, et al. Mortality in early seropositive polyarthritis: cardiovascular mortality is increased in seropositive patients. Arthritis Rhem 2002;46:2010-9.

23. Goodson NJ, Silman AJ, Pattison DJ, et al. Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis. Rheumatology (Oxford). 2004;43(6):731-6.

24. Goodson NJ, Symmons DP, Scott DG, et al. Baseline levels of C-reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis: a ten-year followup study of a primary care-based inception cohort. Arthritis Rheum. 2005;52(8):2293-9.

25. Hansel S, Lassig G, Pistrosch F, Passauer J. Endothelial dysfunction in young patients with long-term rheumatoid arthritis and low dis￾ease activity. Atherosclerosis. 2003;170(1):177-180.

26. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 highrisk individuals: a randomised placebo-controlled trial. Lancet 2002;360:7-22.

27. Hermann F, Forster A, Chenevard R, et al. Simvastatin improves endothelial function in patients with rheumatoid arthritis. J Am Coll Cardiol. 2005;45(3):461-464.

28. Hurlimann D, Forster A, Noll G, et al. Anti-tumor necrosis factoralpha treatment improves endothelial function in patients with rheumatoid arthritis. Circulation 2002;106:2184-2187.

29. Hutchinson D, Shepstone L, Moots R, et al. Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Ann Rheum Dis. 2001;60(3):223-7.

30. Inoue I, Goto S, Mootani K, et al. Lipophilic HMG–CoA reductase inhibitor has an anti–inflammatory effect: reduction of MRNA levels for interleukin–1 beta, interleukin–6. cyclooxygenase–2, and p22phox by regulation of peroxisome proliferator–activated receptor alpha (PPARalpha) in primary endothelial cells. Life Sci 2000;67:863-876.

31. Jacobsson LT, Turesson C, Hanson RL, et al. Joint swelling as a predictor of death from cardiovascular disease in a population study of Pima Indians. Arthritis Rheum. 2001;44(5):1170-6.

32. Jimenez-Alonso J, Jaimez L, et al. Atorvastatin-induced reversible positive antinuclear antibodies. Am J Med. 2002;112(4):329- 330.

33. Kanda H, Hamasaki K, Kubo K, et al. Antiinflammatory effect of simvastatin in patients with rheumatoid arthritis. J Rheumatol. 2002;29(9):2024-2026.

34. Kitas GD, Erb N. Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology (Oxford). 2003; 42(5):607-13.

35. Klareskog L, Hamsten A. Statins in rheumatoid arthritis--two birds with one stone? Lancet. 2004;363:2011-2012.

36. Klocke R, Cockcroft JR, Taylor GJ, et al. Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis. Ann Rheum Dis. 2003;62(5):414-418.

37. Kremers HM, Nicola PJ, Crowson CS, et al. Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis. Arthritis Rheum. 2004;50(11):3450-7.

38. Leung BP, Sattar N, Crilly A, et al. A novel anti-inflammatory role for simvastatin in inflammatory arthritis. J Immunol. 2003;170(3): 1524-1530.

39. Manzi S, Wasko MC. Inflammation-mediated rheumatic diseases and atherosclerosis. Ann Rheum Dis. 2000;59(5):321-325.

40. Maradit-Kremers H, Crowson CS, Nicola PJ, et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum. 2005;52(2):402-411.

41. Maradit-Kremers H, Nicola PJ, Crowson CS, et al. Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum. 2005;52(3):722-32.

42. McCarey DW, McInnes IB, Madhok R, et al. Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebocontrolled trial. Lancet. 2004;363:2015-2021.

43. McCarey DW, Sattar N, McInnes IB. Do the pleiotropic effects of statins in the vasculature predict a role in inflammatory diseases? Arthritis Res Ther. 2005;7(2):55-61.

44. McInnes IB, McCarey DW, Sattar N. Do statins offer therapeutic potential in inflammatory arthritis? Ann Rheum Dis. 2004;63(12): 1535-7.

45. Minaur NJ, Jacoby RK, Cosh JA, et al. Outcome after 40 years with rheumatoid arthritis: a prospective study of function, disease activity, and mortality. J Rheumatol Suppl. 2004;69:3-8.

46. Munro R, Morrison E, McDonald AG, et al. Effect of disease modifying agents on the lipid profiles of patients with rheumatoid arthritis. Ann Rheum Dis. 1997;56(6):374-7.

47. Nicola PJ, Maradit-Kremers H, Roger VL, et al. The risk of congestive heart failure in rheumatoid arthritis: a population-based study over 46 years. Arthritis Rheum. 2005;52(2):412-20.

48. Palmer G, Chobaz V, Talabot-Ayer D, et al. Assessment of the efficacy of different statins in murine collagen-induced arthritis. Arthritis Rheum. 2004;50(12):4051-4059.

49. Pasceri V, Yeh ET. A tale of two diseases: atherosclerosis and rheumatoid arthritis. Circulation. 1999;100(21):2124-6.

50. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) Lancet 1994;344:1383-1389.

51. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000; 342(12): 836-843.

52. Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med. 1999; 340: 115-126.

53. Sattar N, McCarey DW, Capell H, McInnes IB. Explaining how "highgrade" systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003;108(24):2957-2963.

54. Seljeflot I, Tonstad S, Hjermann I, Arnesen H: Reduced expression of endothelial cell markers after 1 year treatment with simvastatin and atorvastatin in patients with coronary heart disease. Atherosclerosis 2002;162:179-185.

55. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med 1995;333:1301-1307.

56. Simons LA, Sullivan DR. Lipid-modifying drugs. Med J Aust. 2005;182(6):286-289.

57. Solomon DH, Karlson EW, Rimm EB, et al. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 2003;107:1303-1307.

58. Tikiz C, Utuk O, Pirildar T, et al. Effects of angiotensin-converting enzyme inhibition and statin treatment on inflammatory markers and endothelial functions in patients with longterm rheumatoid arthritis. J Rheumatol. 2005;32(11):2095-2101.

59. Turesson C, O'Fallon WM, Crowson CS, et al. Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol. 2002;29(1):62-7.

60. Van Doornum S, McColl G, Jenkins A, et al. Screening for atherosclerosis in patients with rheumatoid arthritis: comparison of two in vivo tests of vascular function. Arthritis Rheum. 2003;48(1):72-80.

61. Van Doornum S, McColl G, Wicks IP. Atorvastatin reduces arterial stiffness in patients with rheumatoid arthritis. Ann Rheum Dis. 2004;63(12):1571-1575.

62. Vaudo G, Marchesi S, Gerli R, et al. Endothelial dysfunction in young patients with rheumatoid arthritis and low disease activity. Ann Rheum Dis. 2004;63(1):31-35.

63. Vita JA, Yeung AC, Winniford M, et al. Effect of cholesterol-lowering therapy on coronary endothelial vasomotor function in patients with coronary artery disease. Circulation. 2000;102(8):846-851.

64. Wagner AH, Gebauer M, Guldenzoph B, Hecker M: 3-Hydroxy-3- methylglutaryl coenzyme A reductase-independent inhibition of CD40 expression by atorvastatin in human endothelial cells. Arterioscler Thromb Vasc Biol 2002;22:1784-1789.

65. Wallberg-Jonsson S, Ohman ML, Dahlqvist SR. Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden. J Rheumatol. 1997;24(3):445-51.

66. Wallberg-Jonsson S, Johansson H, et al. Extent of inflammation predicts cardiovascular disease and overall mortality in seropositive rheumatoid arthritis. A retrospective cohort study from disease onset. J Rheumatol. 1999;26(12):2562-71.

67. Weis M, Pehlivanli S, Meiser BM, von Scheidt W. Simvastatin treatment is associated with improvement in coronary endothelial function and decreased cytokine activation in patients after heart trans￾plantation. J Am Coll Cardiol. 2001;38(3):814-8.

68. Wong M, Toh L, Wilson A, et al. Reduced arterial elasticity in rheumatoid arthritis and the relationship to vascular disease risk factors and inflammation. Arthritis Rheum. 2003;48(1):81-89.

For citation:

Anichkov D.A., Shostak N.A. RHEUMATOID ARTHRITIS AND CARDIOVASCULAR RISK: PERSPECTIVES OF TREATMENT WITH STATINS. Rational Pharmacotherapy in Cardiology. 2005;1(3):47-53. (In Russ.)

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