Cytomegalovirus as a Driver of Excess Cardiovascular Mortality in Rheumatoid Arthritis: A Red Herring or a Smoking Gun?

Abstract

Rheumatoid arthritis (RA) is the most common in-flammatory arthritis worldwide. Apart from its well-known manifestations involving the joints (eg, deformity,swelling, and synovial inflammation), there are wide-spread, extra-articular manifestations that also involve thecardiovascular system. 1 The consequences of cardiovascu-lar involvement are often serious; cerebrovascular disease,ischemic heart disease, and cardiovascular disease (CVD)–associated death are ≤50% higher in the context of RAleading to a reduction of life-expectancy in these patientsof 3 to 10 years compared with the general population. 1 Todate, no satisfactory explanation of this phenomenon hasbeen found, or maybe, it has been overlooked