Abstract
BackgroundRheumatoid arthritis (RA) is a condition associated with accelerated progression of atherosclerosis in affected individuals. Myocardial assessment using exercise testing in such patients, however, is often difficult to perform. Our objective was to determine the factors associated with severe coronary stenosis using computed tomography (CT) angiography of the coronary arteries in asymptomatic patients with RA.MethodsForty-four women with RA were examined using CT angiography to detect atherosclerotic involvement and significant coronary stenosis (>50 %). CT findings were correlated with the cardiovascular risk score, and with classical and most recent parameters of atherosclerosis.ResultsCT angiography of the coronary arteries revealed severe stenosis (>70 %) in 9 % of patients. High-sensitivity troponin I level was associated with severe coronary stenosis (odds ratio 6.37; 95 % confidence interval 1.53 − 26.48; P = 0.011). Adjustment for confounders did not alter this result (P = 0.039). In contrast, classical and modified Systemic Coronary Risk Evaluation scores had no value in predicting severe stenosis (P ≥ 0.49).ConclusionThe present study showed the possible benefits of a coronary CT angiography in women with RA and asymptomatic ischemic coronary heart disease. Increased levels of high-sensitivity troponin I may be a potential indication for this type of examination. However, further studies are needed to confirm these results.
Highlights
Rheumatoid arthritis (RA) is a condition associated with accelerated progression of atherosclerosis in affected individuals
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease associated with a higher prevalence of cardiovascular (CV) disease, both of which are linked to the presence of traditional risk factors for atherosclerosis as well as chronic inflammation
The aim of the present study was to detect the following in asymptomatic patients with RA: the prevalence of significant coronary stenosis measured by Coronary computed tomography (CT) angiography (cCTA); how coronary atherosclerosis diagnosed by CT examination correlates with classical or modified cardiovascular Systematic Coronary Risk Evaluation (SCORE) systems; and the predictive value of biomarkers in assessing the severity of coronary stenosis
Summary
Rheumatoid arthritis (RA) is a condition associated with accelerated progression of atherosclerosis in affected individuals. Rheumatoid arthritis (RA) is an inflammatory autoimmune disease associated with a higher prevalence of cardiovascular (CV) disease, both of which are linked to the presence of traditional risk factors for atherosclerosis as well as chronic inflammation. The European League Against Rheumatism (EULAR) recommends multiplying the risk measured by SCORE by a factor of 1.5 in selected RA patients [6]. This applies to patients meeting 2 or more of the following criteria: duration of disease >10 years; positivity for rheumatoid factor or anti-citrulline antibodies; and the presence of certain extra-articular symptoms [6]
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