BackgroundIn a patient with rheumatoid arthritis (RA) manifestations of coronary heart disease occur gradually, at the same time “painless” myocardial ischemia is detected in 50 - 70% of cases according to the literature. According to modern ideas, the formation of endothelial dysfunction, development of early atherosclerosis and vascular thrombosis are closely associated with the increase level of von Willebrand factor (VWF) and inflammatory markers.ObjectivesThe aim of this study was to investigate the frequency and duration of painless myocardial ischemia and its association with VWF levels and inflammatory markers in patients with RA.Methods63 patients with RA (44 women) aged 27 - 65 years (mean age - 46.8 ± 9.8 years) and 69 ages and sex-matched controls were examined. Serum levels of VWF, CRP and TNF-α were determined by enzyme-linked immunosorbent assays. Daily (Holter) ECG monitoring was performed by Holter ECG monitoring systems “DiaCard”, registrar: model 02100, software version 1.0.40, developed by JSC “Solveig” (Ukraine).ResultsIt was found, that the part of patients with painless myocardial ischemia among patients with RA was significantly higher (58.7%) than in the control group (13%). At the same time, in patients with RA the duration of painless myocardial ischemia was in averaged 10.9 ± 8.1 minutes per day. It was significantly more than in the control group 2.88±1.25 minutes per day (p <0,05). It was found, that in patients with RA there was an increased levels of VWF (162.2 ± 9.3% vs. 86.2 ± 2.7% in control). It was found, that the duration of painless myocardial ischemia had close correlations with VWF (r = 0.28), CRP (r = 0.41) and TNF-α (r = 0.40).ConclusionThe severity the duration of painless myocardial ischemia in RA patients is associated with elevated levels of VWF, CRP, and TNF-α, indicating the possible involvement of VWF and inflammatory markers in cardiovascular disease in RA patients.References[1]Hannawi, S., Hannawi, H., Al Salmi I. (2020). Cardiovascular disease and subclinical atherosclerosis in rheumatoid arthritis. Hypertension Research, 43, 982–984Disclosure of InterestsNone declared.
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