Relationship between hsTnI and coronary stenosis in asymptomatic women with rheumatoid arthritis
Milan Hromádka1, Jitka Seidlerová2,3, Jan Baxa1
1Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Insights
High-sensitivity troponin I levels may indicate severe coronary artery stenosis in women with rheumatoid arthritis (RA). Coronary CT angiography is beneficial for assessing cardiovascular risk in these patients.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Rheumatoid arthritis (RA) accelerates atherosclerosis, increasing cardiovascular risk.
- Assessing myocardial function in RA patients via exercise testing is challenging.
- Coronary CT angiography offers an alternative for evaluating coronary artery disease in RA.
Purpose of the Study:
- To identify factors associated with severe coronary stenosis in asymptomatic RA patients.
- To evaluate the utility of coronary CT angiography in this population.
- To explore potential biomarkers for predicting coronary artery stenosis in RA.
Main Methods:
- Coronary CT angiography was performed on 44 women with RA.
- Assessment included detection of atherosclerotic involvement and significant coronary stenosis (>50%).
- CT findings were correlated with cardiovascular risk scores and atherosclerosis parameters, including high-sensitivity troponin I.
Main Results:
- Severe coronary stenosis (>70%) was detected in 9% of patients.
- Elevated high-sensitivity troponin I levels were significantly associated with severe coronary stenosis (OR 6.37, P=0.011).
- Traditional cardiovascular risk scores did not effectively predict severe stenosis in this cohort.
Conclusions:
- Coronary CT angiography is a valuable tool for assessing asymptomatic ischemic heart disease in women with RA.
- Increased high-sensitivity troponin I levels may serve as an indicator for coronary CT angiography in RA patients.
- Further research is necessary to validate these findings and their clinical implications.
Background:
Rheumatoid 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.
Methods:
Forty-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.
Results:
CT 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).
Conclusion:
The 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.
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