Post Chikungunya Chronic Arthritis: Systemic Inflammatory Status Triggering Acute Coronary Syndrome
Dhruvkumar M Patel1, Mukundkumar V Patel2, Kamal H Sharma3
1Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India.
Current Rheumatology Reviews
|August 17, 2018
Summary
Post Chikungunya Chronic Arthritis (PCCA) is common in Acute Coronary Syndrome (ACS) patients. This post-infective inflammation may destabilize coronary plaques, increasing ACS risk.
Area of Science:
- Cardiology
- Rheumatology
- Infectious Diseases
Background:
- Atherosclerosis, inflammation, and coronary plaque destabilization are interconnected.
- Infections can trigger Acute Coronary Syndrome (ACS) via systemic inflammation.
Purpose of the Study:
- To evaluate the prevalence of Post Chikungunya Chronic Arthritis (PCCA) in ACS patients.
- To compare PCCA prevalence between ACS patients and a control group undergoing elective surgery.
Main Methods:
- A prospective case-control observational study involving 400 ACS patients and 400 controls.
- Exclusion criteria included unmet ACS criteria, recent myocardial infarction in controls, and prolonged PCCA or positive IgM anti-CCP.
Main Results:
- PCCA was present in 6% of ACS cases versus 2% of controls (OR 3.0, 95% CI 1.4-6.4).
- ACS patients with PCCA were younger, more often women, and had higher rates of diabetes, hypertension, chronic kidney injury, and CRP.
- Adjusted analysis confirmed PCCA was three times more common in ACS patients (OR 3.0, 95% CI 1.3-6.8).
Conclusions:
- Post Chikungunya Chronic Arthritis (PCCA) is a common comorbidity in Acute Coronary Syndrome (ACS) patients.
- Systemic inflammation associated with PCCA may contribute to coronary plaque destabilization and ACS development.
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