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Heart involvement in rheumatoid arthritis: systematic review and meta-analysis

Salvatore Corrao1, Silvia Messina, Giovanni Pistone

  • 1Centre of Research for Effectiveness and Appropriateness in Medicine, Biomedical Department of Internal Medicine and Subspecialties, University of Palermo, Palermo, Italy; National Relevance Hospital Trust, Unit of Internal Medicine II, Outpatient Rheumatology Clinic, ARNAS Civico, Di Cristina e Benfratelli, Palermo, Italy. s.corrao@tiscali.it

International Journal of Cardiology
|June 19, 2012
PubMed

Insights

Rheumatoid Arthritis (RA) patients show significant pericardial and valvular heart involvement, even without cardiovascular symptoms. Echocardiography is crucial for RA research, and further studies are needed to explore links to cardiovascular mortality.

Area of Science:

  • Cardiology
  • Rheumatology
  • Systematic Review & Meta-Analysis

Background:

  • Rheumatoid Arthritis (RA) is a systemic autoimmune disease.
  • Cardiac involvement in RA is a significant concern, particularly in asymptomatic patients.
  • Understanding valvular and pericardial impact is crucial for patient management.

Purpose of the Study:

  • To systematically review and meta-analyze case-control studies on cardiac involvement in RA patients.
  • To assess the association between RA and pericardial effusion and valvular abnormalities.
  • To evaluate cardiac involvement in RA patients asymptomatic for cardiovascular diseases.

Main Methods:

  • Systematic search of PubMed and Cochrane CENTRAL (1975-2010).
  • Inclusion of case-control studies focusing on adult RA patients without cardiovascular symptoms.
  • Meta-analysis of quantitative data on cardiac involvement outcomes.

Main Results:

  • RA is significantly associated with pericardial effusion (OR 10.7).
  • Valvular involvement includes nodules (OR 12.5), insufficiency (tricuspid: 5.3, mitral: 3.4, aortic: 1.7), stenosis (aortic: 5.2), thickening/calcification (mitral: 5.0, aortic: 4.4, general: 4.8), and prolapse (mitral: 2.2).
  • Combined valvular alterations showed a significant association (OR 4.3).

Conclusions:

  • RA patients exhibit significant pericardial and valvular heart involvement.
  • Echocardiographic assessment is recommended for RA patients in clinical research.
  • Further research is necessary to link these cardiac findings to increased cardiovascular mortality.
Abstract

Keywords:
Cardiac valvular calcificationEchocardiography assessmentMeta-analysisPericardial diseaseRheumatoid ArthritisSystematic review

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