Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UMLS:C0027121 (
myositis
)
4,538
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Systemic autoimmune diseases are becoming increasingly linked to accelerated risks of cardiovascular disease and events. What is apparent from the above review is that the
IIM
are not an exception to this growing pattern. Although not always clinically apparent, there seems to be a large percentage of patients who have subclinical CV involvement. Many of the traditional risk factors for
CAD
, such as hypertension and hyperlipidemia, are associated with developing cardiac involvement in patients with
IIM
. At this time, it is unclear how much of the atherosclerotic CV morbidity and mortality in
IIM
patients is driven by traditional CV risk factors versus the effects of chronic systemic inflammation from the underlying
IIM
. The effects of immunosuppression on cardiac disease and events in
IIM
patients requires further investigation in carefully controlled studies.
IIM
patients with cardiac involvement are at increased risk for overall mortality when compared with
IIM
patients without CV disease. The risk of severe cardiac and vascular disease complications seems to be higher than that of the general population. Treatments can be focused on preventing traditional cardiovascular risk factors including avoidance of corticosteroids when possible, although this task remains challenging in
IIM
as is true of other rheumatic diseases. Once complications do develop, they should be managed similarly to patients without
IIM
. The use of statins for hyperlipidemia and atherosclerosis in
IIM
is an area that is in need of further investigation, although initial work suggests that their use is not uncommon by
IIM
specialists. Further work is needed to determine whether aggressive immunosuppressive treatment of patients with subclinical cardiac disease will lead to better outcomes. Work is also needed in the area of better laboratory, imaging, and serologic testing to identify patients at risk for the worst cardiovascular complications. At this point, based on the body of evidence reviewed here and elsewhere, it is imperative that physicians treating
IIM
patients performa routine cardiovascular risk assessment at the onset of diagnosis. Appropriate diagnostic and monitoring studies should be performed on those patients who screening history or examination is suggestive of cardiac involvement.
...
PMID:The heart in inflammatory myopathies. 2426 6