Genetic relationship between rheumatoid arthritis and cardiovascular diseases : Asystematic review of Mendelian randomization studies.

Abstract

Rheumatoid arthritis (RA) is recognized as achronic autoimmune disorder with systemic inflammation and joint damage. Its potential role as arisk factor for cardiovascular diseases (CVD) is increasingly noted. This review delves into the causal relationship between RA and CVD, with Mendelian randomization (MR) offering agenetic perspective. An extensive search was conducted in PubMed, Cochrane and Web of Science to identify MR studies addressing the RA-CVD link. Out of 530 studies, 9 met the inclusion criteria, which were rigorously assessed using acritical appraisal checklist. These were further stratified by asensitivity analysis into categories reflecting the strength of their evidence, from not evaluable to robust. From the nine included studies, eight supported acausal association between RA and an increased risk of CVD, specifically coronary artery disease (CAD) and one did not support alink between RA and heart failure. The results suggest that genetic factors associated with RA may contribute to an elevated risk for CVD. Chronic inflammation, prevalent in RA, emerges as akey mediator in this connection. The systematic review corroborates agenetic causal link between RA and CVD, as evidenced by eight of the nine MR studies reviewed. This suggests aneed for integrated cardiovascular risk management in the treatment of RA patients. The findings advocate considering anti-inflammatory treatment that can reduce cardiovascular risk. The overarching evidence signifies apotential direction for new therapeutic strategies aimed at enhancing cardiovascular health in RA patients.