‘It takes a village’ to manage cardiovascular disease in patients with IMIDs
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Properly managing cardiovascular disease in patients with immune-mediated inflammatory diseases requires following guidelines and inter-specialty collaboration, according to a speaker at the Biologic Therapies Summit.
“Let’s switch gears to management, and specifically, management in patients who have been diagnosed with some sort of cardiovascular event,” Pulkit Chaudhury, MD, MS, FSVM, FACC, RPVI, of the Cleveland Clinic, told attendees. “That will change how you manage both their lipids and it may change how you manage their immunosuppressants.”
According to Chaudhury, most patients who fit into these parameters should meet some specific care guidelines and standards when it comes to atherosclerosis.
“You will find that most of these patients should be on some kind of guideline-directed anti-platelet and a vasoactive agent,” he said. “They should be following with the appropriate specialist, whether it is a cardiovascular physician or a neurologist, depending on the initial cardiovascular event.”
added that these patients should all be considered high risk or very high risk — should be managed as such.
he said. “The ship has sailed at that point.”
Regarding targets for critical lipid measurements, Chaudhury notes that there are a several variables that will come into play.
“Their targets will depend on a variety of things,” he said. “But, for most of them, your ideal goal is less than 70, and certainly in some cases less than 55 for premature atherosclerosis.”
For certain patients, low-dose anticoagulation therapy may be beneficial. In this specific population, Chaudhury said, venous thromboembolism is a genuine concern.
for recurrent events,” he said. “That can be tricky in a patient with an immune-mediated inflammatory disease, because the risk for recurrent VTE is in part determined by the underlying etiology of that initial VTE event.”
As care algorithms and standards become more complex, it is increasingly clear that collaboration leads to optimal outcomes, according to Chaudhury.
“We want to strive to give our patients the best care possible,” he said. “And it often takes a village.”
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Chaudhury P. Cardiovascular disease in immune mediated inflammatory diseases. Presented at: Biologic Therapies Summit X; May 11-13, 2023 (hybrid meeting).
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