Abstrakt
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. 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. 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 MINUS SIGN 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 GREATER-THAN OR EQUAL TO 0.49). 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.