Патогенетические аспекты коморбидной ассоциации хронической сердечной недостаточности и ревматоидного артрита

Abstract

The purpose — to analyze the frequency of anemia and decreased glomerular filtration rate (GFR) in patients with chronic heart failure (CHF) and rheumatoid arthritis (RA) and to identify the possible associations of these indicators with the systemic inflammation parameters and the CHF course. Material and methods. The main group consisted of 134 patients with CHF and RA, the comparison group — of 122 patients without RA. The functional class (FC) of CHF was identified according to NYHAI-II. The diagnosis of RA was made on the basis of radiological and serological studies. The radiological stage of RA was I-III according to Steinbrocker. The basic anti-inflammatory drug for RA was methotrexate. A comparative analysis of clinical and laboratory parameters was carried out for patients of both groups, as well as a possible association of hemoglobin levels and GFR with RA activity indicators and CHF severity parameters. The processing was carried out using the STATISTICA 10.0 program. The critical level of significance when testing statistical hypotheses was p < 0.05. Results. Statistically significant differences in the frequency of anemia and a decrease in GFR were revealed between the examined groups. In the group of patients with CHF and RA, direct statistically significant associations of hemoglobin and GFR levels with LVL were revealed, as well as statistically significant associations of hemoglobin and GFR levels with NT-proBNP levels and DAS28 values. Conclusion. Statistically significant associations between the studied parameters were observed in patients with CHF and RA against the background of systemic inflammation, which may negatively affect the course of CHF.