Table 6

Common risk factors in the pathogenesis of atherosclerosis underlying rheumatic diseases

1. Traditional

Age

Smoking

Dyslipidemia

Hypertension

Diabetes mellitus

Immobilization

Sedentary lifestyle

2. Inflammatory

Acute-phase proteins (C-reactive protein, fibrinogen)

Lipoprotein (a)

Folate and vitamin B12 deficiency

Decreased paraoxonase activity

CD4+/CD28- T cells

Autoantibodies (anti-CCP, rheumatoid factor, anti-oxLDL, anti-phospholipid antibody, anti-hsp)

Proatherogenic cytokines (tumor necrosis factor-alpha, interleukin-6)

Chemokines

Angiogenic growth factors

Matrix-degrading metalloproteinases

Increased cell adhesion molecule expression

Hyperhomocysteinemia

Defective apoptosis

3. Iatrogenic

Methotrexate – bimodal?

Corticosteroids – bimodal?


anti-CCP, anti-cyclic citrullinated peptide; anti-oxLDL, anti-oxidized low-density lipoprotein.

Szekanecz and Koch Arthritis Research & Therapy 2008 10:224   doi:10.1186/ar2515