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Atherosclerosis is an Infectious Disease

Aim Rheumatoid arthritis (RA) is associated with increased risk of coronary artery disease (CAD). Studies reported that anti-rheumatic drug usage is associated with decreased risk of CAD events in RA patients. This study was conducted to investigate the effect of some anti-inflammatory drugs (etanercept, leflunomide, etoricoxib) on the development of CAD events among patients with RA using anti-rheumatic drug in comparison with nonusers. Methods A systematic review of CAD events in RA patients was performed who used leflunomide, etanercept and etoricoxib and was compared with RA patients who don’t use these drugs. The exclusion relationship and the causal relationship k were used to test the significance of the result. A p-value of < 0.05 was treated as significant. Results Among RA patients, use of leflunomide (p (EXCL) =0,999022483; X2 (EXCL) = 0,06; k = -0,03888389; p-value ( k | HGD) =0,00037588), etanercept and etoricoxib was associated with significantly decreased incidence of CAD. The use leflunomide, etanercept and etoricoxib excludes cardiac events in RA patients. Conclusion The results of study provide further support for the infectious hypothesis of atherosclerosis. Key words: atherosclerosis, rheumatoid arthritis, therapy, causal relationship