Relationship between hsTnI and coronary stenosis in asymptomatic women with rheumatoid arthritis

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.

Correlation of rheumatoid and cardiac biomarkers with cardiac anatomy and function in rheumatoid arthritis patients without clinically overt cardiovascular diseases: A cross-sectional study

“…Cardiovascular disease (CVD) is a major cause of death in RA patients [2] , [4] , and cardiovascular mortality is increased by 20–50% in RA patients, compared with that in patients without RA [5] , [6] . Moreover, the incidence of myocardial infarction, arrhythmia, pericardial disease, and left ventricular (LV) dysfunction is higher in RA patients than in the general population [4] , [7] , [8] . Additionally, RA patients have significantly worse LV systolic and diastolic function, especially patients with active disease [9] , [10] .…”

Findings on Coronary Angiographies in Patients With Rheumatoid Arthritis and Ischemic Heart Disease: Are They Different From Patients Without Rheumatoid Arthritis?

“…With regard to CV characteristics in RA, studies indicate that patients with RA have an increased carotid intima-media thickness (IMT) (7)(8)(9)(10)(11), and that the prevalence and perhaps severity of coronary artery calcification is increased (12)(13)(14)(15)(16)(17). Notably, these results pertain to patients with RA in the absence of acute ACS.…”

Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers

“…In RA patients, it is known that CAC is more frequent and severe than in age‐ and gender‐matched control subjects, more common in established RA and in those with more severe disease, and relates with the number and severity of coronary stenosis . The risk of CAC progression seems to be also higher in RA patients than in the general population .…”

“…12,13 In RA patients, it is known that CAC is more frequent and severe than in age-and gender-matched control subjects, 11,14,15 more common in established RA 16 and in those with more severe disease, 17 and relates with the number and severity of coronary stenosis. 18 The risk of CAC progression seems to be also higher in RA patients than in the general population. 19 The presence of CAC in newly diagnosed RA patients has also been shown and these had a small progression rate during a 2 year follow-up period.…”