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Cardiovascular Disease in Juvenile Idiopathic Arthritis

[ Vol. 18 , Issue. 6 ]

Author(s):

Elisavet Arsenaki, Panagiotis Georgakopoulos, Panagiota Mitropoulou, Evangelia Koutli, Konstantinos Thomas, Marietta Charakida and Georgios Georgiopoulos*   Pages 580 - 591 ( 12 )

Abstract:


Juvenile idiopathic arthritis (JIA), is a term used to describe a group of inflammatory disorders beginning before the age of 16 years. Although for the majority of children remission is achieved early, those with systemic or polyarticular form of the disease may present persistent symptoms in adulthood. Considering that there is overlap in the pathogenesis of JIA with adult rheumatic diseases, concerns have been raised as to whether JIA patients could be at increased cardiovascular (CV) risk in the long-term. In this review, we summarize evidence for CV involvement in JIA and present data on CV risk factors and surrogate markers of arterial disease. We also provide information on beneficial and harmful CV effects of anti-inflammatory medications in the context of JIA and suggest strategies for CV screening. Overall, patients with systemic forms of JIA demonstrate an adverse lipid profile and early arterial changes relevant to accelerated arterial disease progression. Although there is paucity of data on CV outcomes, we recommend a holistic approach in the management of JIA patients, which includes CV risk factor monitoring and lifestyle modification as well as use, when necessary, of antiinflammatory therapies with documented CV safety.

Keywords:

Juvenile idiopathic arthritis, cardiovascular, surrogate markers, outcomes, disease, inflammatory.

Affiliation:

St. George’s University of London, London, National Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Queen Alexandra Hospital, Portsmouth, UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, School of Biomedical Engineering and Imaging Sciences, King’s College, London, School of Biomedical Engineering and Imaging Sciences, King’s College, London

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