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[The coronary arteries and the determinants of coronary atherosclerosis in rheumatoid arthritis]

A V Sineglazova

    Vestnik Rentgenologii I Radiologii
    |December 11, 2012
    PubMed

    Insights

    Patients with rheumatoid arthritis (RA) show increased coronary artery atherosclerosis, including more severe stenosis and plaques. This cardiovascular risk is linked to RA activity, menopause duration, and lipid levels.

    Area of Science:

    • Cardiology
    • Rheumatology
    • Radiology

    Background:

    • Rheumatoid arthritis (RA) is a systemic autoimmune disease.
    • Cardiovascular disease is a significant comorbidity in RA patients.
    • The extent of coronary artery atherosclerosis in RA patients requires further investigation.

    Purpose of the Study:

    • To evaluate the prevalence and characteristics of coronary artery atherosclerosis in women with RA compared to a control group.
    • To identify factors associated with coronary artery atherosclerosis in RA patients.

    Main Methods:

    • A cohort of 32 RA patients and 21 controls underwent coronary artery examination using a GE LightSpeed VCT 64-slice computed tomograph.
    • Coronary calcium was quantified using SmartScore software and the Agatston score.
    • Statistical analysis was performed to correlate findings with clinical and laboratory parameters.

    Main Results:

    • Coronary artery changes were diagnosed in 44% of RA patients versus 19% in controls.
    • Coronary artery calcification was detected in 27% of RA patients, often with multiple lesions and severe stenosis.
    • Hemodynamically relevant stenoses were exclusively found in RA patients.
    • Atherosclerosis correlated with menopause duration, elevated total cholesterol and LDL, low superoxide dismutase, high RA activity, and joint involvement.
    • Coronary stenosis severity was associated with systolic blood pressure.

    Conclusions:

    • RA patients exhibit a higher burden of coronary artery atherosclerosis, including more severe and hemodynamically significant lesions.
    • Factors such as disease activity, lipid profile, and menopausal status contribute to cardiovascular risk in RA.
    • Early detection and management of cardiovascular risk factors are crucial in RA management.

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