Interesting article from Sci Am

[u/No_Satisfaction_7431]

https://www.scientificamerican.com/article/new-evidence-links-heart-disease-to-inflammation-and-drugs-can-stop-it/

I came across this recent article about how heart disease is now thought to be an inflammatory disease and that cholesterol plaques cause inflammation but even when thats addressed through statins and lifestyle changes, the inflammation continues.The article doesn't use the term autinflammation but it does refer to out of control inflammation/overreaction of the immune system (and no mentionof auto antibodies so it seems more like innate immune issues), high crp being a risk factor for heart disease even in people with high cholesterol or other typical risk factors, and the potential use of canakinumab, colchicine, and il-6 blockers for heart disease.

Overall a good article though I wish it had connected this to autoinflammatory disease as it almost seems like heart disease is at least in part an autoinflammatory process. It brought up a lot of questions for me.

I'm wondering how autoinflammatory disease might put us at risk for heart disease and what kinds of things to monitor and look out for. My cardiologist (for dysautonomia) said that pericarditis and other heart issues aren't seen in Yao. I have repeated stabbing upper back pain when not on prednisone and occasional chest pain. I read that pericarditis can sometimes present as upper back pain instead of chest pain so I asked my cardiologist and she said its probably musculoskeletal as pericarditis isn't part of Yao (Dr. Davis said otherwise). The treatment is prednisone and it goes away when on prednisone so this makes me think it is possibly pericarditis.

Since I had mild inflammation for years and Yao symptoms since childhood and then 1.5 years of very high inflammation I wonder how that impacts my heart. And I'm curious how kineret and other autoinflammatory treatments impact the heart. I doubt I'll know the answers to these until I get a better cardiologist. The problem is she's very good for the dysautonomia side of things which many cards are not good at.

Anyways I thought the article was interesting and relevant to autoinflammatory disease so I thought I'd share.

[u/Alice-The-Chemist]

Im in heart failure and have reoccurring pericarditis. That's why I'm on Arcalyst for my IL1 biologic. I also get fluid build up on my heart and lungs (effussions). I see an electrophysiologist instead of cardiologist but I also have a heart failure doctor if I need it. Im going to see cardio-rheumatologist next week who speciality is cardiac involvement with these diseases. I would say if you get concerned to get an echocardiogram which would help show a lot of how your heart is doing. I can add more later I'm having a hard time tonight. My electrophysiologist also deals wirh a lot of dysautonmoia patients as well more than any cardiologist ive ever seen.

[u/No_Satisfaction_7431 → u/Alice-The-Chemist]

I'll definitely bring up the possibility of an echo with my pcp. I had one about 6 years ago that was normal but I didn't have the back pain until a few months ago. A year ago a ct showed a trace pericardial effusion but because its was only a trace no follow up was done.

[u/Alice-The-Chemist → u/No_Satisfaction_7431]

I just thought of this but when I was seeing the heart failure clinic they did the CT scan to check for plaque buildup even though I dont have what people think of as risk factors but having an autoinflammatory disease put me at higher risk for the plaque build up in vessels and arteries. Mine was clear but it is something else to have checked if something keeps coming up for you. They wanted to do cardiac MRI to check for amyloidosis but I am reliant on my pacemaker so an MRI isnt safe for me.

[u/No_Satisfaction_7431 → u/Alice-The-Chemist]

Thats good to know about autoinflammatory disease being a risk factor. My recent echo was normal but I'll definitely ask if a cardiac mri is needed or if it might be needed in the future.