Infections as Novel Risk Factors of Atherosclerotic Cardiovascular Diseases: Pathophysiological Links and Therapeutic Implications

Journal of Clinical Medicine

卷:10

Krzysztof J. Filipiak¹  Aleksandra Gąsecka¹  Piotr Szwed¹  Tomasz Mazurek¹  Mateusz Zawadka²  Ceren Eyileten³  Marek Postuła³  Łukasz Szarpak⁴ 

[1] 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland;

[2] 2nd Department of Anaestesiology and Intensive Therapy, Medical University of Warsaw, 02-097 Warsaw, Poland;

[3] Department of Experimental and Clinical Pharmacology, Center for Preclinical Research and Technology Medical University of Warsaw, 02-097 Warsaw, Poland;

[4] Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland;

关键词: atherosclerosis;    cardiovascular disease;    infections;    outcomes;    risk factors;   

DOI  :  10.3390/jcm10122539

来源: DOAJ

【 摘 要 】

Atherosclerotic cardiovascular diseases (ASCVD) are the major cause of mortality worldwide. Despite the continuous progress in ASCVD therapy, the residual risk persists beyond the management of traditional risk factors. Several infections including Helicobacter pylori infection, periodontal disease, and viral infections are associated with the increased risk of ASCVD, both directly by damage to the heart muscle and vasculature, and indirectly by triggering a systemic proinflammatory state. Hence, beyond the optimal management of the traditional ASCVD risk factors, infections should be considered as an important non-classical risk factor to enable early diagnosis and appropriate treatment. Here, we summarized the currently available evidence regarding the role of inflammation in ASCVD and the association between the particular infections and pathogens (Helicobacter pylori, periodontal disease, pneumonia, Cytomegalovirus, Human immunodeficiency virus, Herpes simplex virus, and severe acute respiratory syndrome coronavirus 2) on the development and progression of ASCVD. We also speculated about the potential therapeutic implications of the anti-inflammatory and anti-infective drugs on ASCVD outcomes, including drugs routinely administered in patients with ASCVD (statins, P2Y12 receptor inhibitors, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) and novel strategies aiming at residual risk reduction (colchicine, anti-cytokine drugs, and methotrexate). Considering the emerging association between infections and ASCVD, it is crucial to determine the possible advantages of infection prevention and treatment in patients with ASCVD.

【 授权许可】

Unknown