Prevention of Stroke in Rheumatoid Arthritis

摘要: Recognizing that systemic inflammation is a major contributor to the increased risk of cardiovascular disease (CVD), including stroke, in rheumatoid arthritis (RA) serves as basis for prevention strategies cerebrovascular RA. In addition traditional factors, recognize RA may be an independent factor accident (CVA). The CVD should assessed each patient with RA, utilizing modified score calculators. Careful monitoring and control undertaken conjunction assessing patient’s risk, acknowledging benefits risks specific RA-directed therapies. Emphasis given early aggressive patients, particularly those seropositivity, inflammatory markers, long duration (>10 years), and/or extra-articular manifestations. patients requiring glucocorticoid therapy, attempts made use or wean minimal effective dose (preferably less than 7.5 mg/day). It recognized both disease-modifying antirheumatic drugs (DMARDs), methotrexate, tumor necrosis (TNF)-alpha inhibitors partially mitigate CVD. inadequate DMARDs, consideration switch anti-TNF agents earlier process. Modifiable factors addressed per guidelines general population. Active considered equivalent diabetes mellitus when applying these guidelines. With regard lipid management statin further studies are required apparent “lipid paradox” Use aspirin primary has not been well studied; however, used secondary prevention, one concomitant nonsteroidal anti-inflammatory (NSAIDs) decrease antiplatelet effect. Given associated NSAIDs, lowest possible shortest time used.