General Features and Differences of Cardiovascular Complications in Rheumatoid Arthritis and Ischemic Heart Disease: Analysis of Pathogenetic Mechanisms and Opportunities for Differential Assessment

Uzun K.¹, Gnylorybov A.², Uzun D.¹, Sevastiіanova N.³, Kuzevanova М.⁴, Potapov Yu.⁵

• ¹Mariupol regional intensive care hospital, Kyiv, Ukraine
• ²M. Amosov National Institute of Cardiovascular Surgery, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
• ³Clinical Diagnostic Center of the State Scientific Institution «Center for Innovative Healthcare Technologies» of the State Administration of Affairs, Kyiv, Ukraine
• ⁴Shupyk National University of Health Care, Kyiv, Ukraine
• ⁵Donetsk National Medical University, Lyman, Ukraine

Summary. This article presents a literature review analyzing the relationship between rheumatoid arthritis (RA) and cardiovascular diseases (CVD). RA is recognized as an independent risk factor for the development of ischemic heart disease (IHD) due to the chronic inflammation that underlies this condition. CVD is observed in approximately 30% of patients with RA over the age of 40 and is the leading cause of premature death. The excess of cardiovascular events in patients with RA results from a combination of traditional risk factors and RA-specific inflammatory processes. Currently, there is no established algorithm for assessing CVD risk in patients with RA. The SCORE tool, used to evaluate CVD risk in the general population, has certain limitations in the context of RA. EULAR suggests applying a 1.5 multiplier to the SCORE results for such patients. Modern EULAR recommendations emphasize the crucial role of rheumatologists in monitoring and standardizing CVD risk management in patients with RA, highlighting the importance of suppressing chronic inflammation. EULAR also stresses the need for careful control of traditional risk factors to minimize potential cardiovascular complications. Thus, the article presents a literature analysis confirming the significant impact of RA on the development of cardiovascular complications. These conditions are caused not only by IHD-specific manifestations but also by RA-specific mechanisms that require further clarification. The lack of precise understanding of the pathogenic causes for increased cardiovascular risks in this disease complicates effective individual prevention and treatment of cardiovascular complications and necessitates the development of new methods for their visualization and management.