Patients with rheumatic diseases like rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) remain inherently at risk for cardiac diseases due to the effects of systemic inflammation combined with immunologic activation and antibody formation targeting specific organs. Examples include coronary artery disease, associated ischemic and non-ischemic heart failure, myocarditis, and interstitial lung disease. While treatment with disease modifying anti-rheumatic drugs (DMARDs) adequately controls primary disease activity (clinically, skin and joints; serologically with reduction of inflammatory/disease activity markers), the effects of DMARDs on inciting or ameliorating/worsening pre-existing cardiac diseases associated with rheumatic diseases, are hotly contested.
