Characteristics Associated With Detectable High-Sensitivity Cardiac Troponin in Patients With Rheumatoid Arthritis at...

Area of Science:

• Cardiology
• Rheumatology
• Biomarkers

Background:

• Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
• Subclinical myocardial injury, indicated by detectable high-sensitivity cardiac troponin T (hs-cTnT), is linked to adverse cardiac events in RA.
• Identifying factors associated with detectable hs-cTnT in RA patients with low to intermediate atherosclerotic cardiovascular disease (ASCVD) risk is crucial for risk stratification.

Purpose of the Study:

• To identify factors associated with detectable hs-cTnT in patients with RA at low to intermediate ASCVD risk.
• To determine if clinical factors and available biomarkers predict detectable hs-cTnT independently of ASCVD risk scores.

Main Methods:

• A cross-sectional cohort study of 294 RA patients without pre-existing CVD or high ASCVD risk (>20%).
• Univariable analysis compared demographics, RA clinical factors, inflammation markers, and lipids between patients with and without detectable hs-cTnT.
• Multivariable logistic regression models were used to identify independent predictors of detectable hs-cTnT.

Main Results:

• 29% (86/294) of RA patients had detectable hs-cTnT.
• Detectable hs-cTnT was associated with older age, male sex, hypertension, elevated inflammatory markers (hs-CRP, IL-6), lipoprotein-associated phospholipase A2, glucocorticoid use, and absence of methotrexate use.
• Higher 10-year ASCVD risk was associated with detectable hs-cTnT (OR 1.22); however, inflammatory markers were not significant in multivariable analysis.
• In the lowest ASCVD risk category (<5%), over 25% of men and 33% of patients >60 years had detectable hs-cTnT.

Conclusions:

• Detectable hs-cTnT is prevalent in RA patients with low to intermediate ASCVD risk.
• Male sex and age >60 are key factors associated with detectable hs-cTnT in this population.
• These findings suggest a need for enhanced cardiovascular screening in older male RA patients, irrespective of their calculated ASCVD risk.