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Annu Rev Med. 2013;64:249-63. doi: 10.1146/annurev-med-060911-090007. Epub 2012 Sep 27.

Mechanisms of premature atherosclerosis in rheumatoid arthritis and lupus.

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Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-5680, USA.


Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), the two most common systemic autoimmune disorders, have both unique and overlapping manifestations. One feature they share is a significantly enhanced risk of atherosclerotic cardiovascular (CV) disease that significantly contributes to morbidity and mortality. The primary mechanisms that drive CV damage in these diseases remain to be fully characterized, but recent discoveries indicate that distinct inflammatory pathways and immune dysregulation characteristic of RA and SLE likely play prominent roles. This review focuses on analyzing the major mechanisms and pathways potentially implicated in the acceleration of atherothrombosis and CV risk in SLE and RA, as well as in the identification of putative preventive strategies that may mitigate vascular complications in systemic autoimmunity.

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