Title:Rheumatoid Arthritis: Genetic Variants as Biomarkers of Cardiovascular Disease
VOLUME: 21 ISSUE: 2
Author(s):Luis Rodriguez-Rodriguez, Raquel López-Mejias, Benjamín Fernández-Gutiérrez, Alejandro Balsa, Miguel A. González-Gay and Javier Martín
Affiliation:Rheumatology Department, Hospital Clinico San Carlos, IdISSC, c Profesor Martín Lagos s/n, 28040, Madrid, Spain.
Keywords:Rheumatoid arthritis, outcome, polymorphism, cardiovascular disease.
Abstract:Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with premature mortality, severe morbidity, and functional
impairment leading to considerable financial burden for both patients and society. Since disease progression and complications can
differ from one patient to another, genetic markers are of potential relevance for identifying those individuals at a higher risk of more severe
disease. RA is a complex polygenic disease. Cardiovascular (CV) disease due to accelerated atherogenesis is the most common
cause of premature mortality in patients with RA. Several studies support the implication of genetic factors in the development of CV
disease in RA. In addition to the strong association between alleles of the HLA-DRB1*04 shared epitope and both subclinical and clinically
evident CV disease, genes implicated in inflammation and metabolism, such as TNFA, MTHFR, and CCR5, seem to be associated
with a higher risk of CV disease in patients with RA. We propose the use of these genetic variants as molecular biomarkers that could
help to predict disease outcome at diagnosis of RA and, therefore, to optimize the treatment and management of other risk factors from an
early stage of the disease.