RISK FACTORS FOR CORONARY ARTERIES DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Now health care professionals who manage patients and stick to holistic patient-cantered approach are facing the problem of “polymorbidity”. The most common conditions complicating rheumatic diseases are cardiovascular diseases, interstitial lung disease, osteoporosis, chronic kidney disease, malignancies and depression. Despite the success in treatment of rheumatoid arthritis, the mortality rate in this category of patients remains higher than in the general population. This is associated with the acceleration of atherosclerosis progression and the early-age onset of coronary arteries disease. Therefore, rheumatoid arthritis is considered as a predictor of coronary arteries disease. The incidence of myocardial infarction, heart failure, and sudden coronary death in patients with rheumatoid arthritis is found to be 3 to 5 times higher than in the general population. The purpose of the present study was to estimate and evaluate comorbidity status in patients with rheumatoid arthritis. The study was performed at the at the Regional Medical and Diagnostic Centre of Rheumatologic Diseases, M.V. Sklifosovskyi Poltava Regional Clinical Hospital, which is the clinical base of the Department of Family Medicine and Therapy, Ukrainian Medical Stomatological Academy. The study included 135 patients with rheumatoid arthritis aged 32 – 65, who made up the main group. The control group consisted of 30 patients without autoimmune diseases, inflammatory conditions and other diseases in acute phase. All patients stated the consent to participate in the study in writing. During the study, all the participants passed through clinical examination including blood tests, urine tests, blood biochemistry, electrocardiography, echocardiography, X-rays of the joints, and ultrasound examinations (by using an apparatus of class “Radmir ultima”). 68.2% of the patients in the main group suffering from rheumatoid arthritis were found out to have different comorbidities compared with the control group. Cardiovascular diseases and especially coronary arteries disease were detected in 42.3% of cases and found out as the most prevalent comorbid diseases in the patients with rheumatoid arthritis. We also revealed the high prevalence of dyslipidemia (73, 4% of cases). It is necessary to underline that 75% of patients in the main group were diagnosed to have even 2 or more comorbidities. According to the results obtained, the majority of the patients suffering from rheumatoid arthritis have comorbidities, which can seriously affect the course of rheumatic diseases and influence the treatment. Management of patients with rheumatoid arthritis and comorbid conditions should be supported by rheumatologists, family doctors, internists in order to evaluate all polymorbidities in their interactions and to provide proper assistance for patients in making their therapeutic course decisions. Of course, this requires novel data from experts to improve diagnostic and treatment approaches of rheumatoid arthritis in its early stage.