Subclinical coronary artery calcification and relationship to disease duration in women with rheumatoid arthritis.
OBJECTIVE
To examine the association between disease duration of rheumatoid arthritis (RA) and the presence and extent of coronary artery calcification (CAC) in women with RA.


METHODS
In this cross-sectional study, 185 women with RA duration of at least 2 years and no clinical cardiovascular disease completed electron-beam tomography (EBT) scans and risk factor assessment. Multivariable logistic regression was used to associate RA duration quartiles with subclinical CAC and extent of CAC.


RESULTS
Age was similar across the quartiles of RA duration. Patients with RA > 23 years had significant increased odds (unadjusted OR 2.60, 95% CI 1.21 5.53) of having more extensive CAC compared to the referent group, those with RA for 2 7 years. This association remained significant after adjustment for traditional coronary heart disease (CHD) risk factors and RA-related covariates. Patients with intermediate RA duration (8 13 yrs) were more likely to have presence of any CAC (OR 3.03, 95% CI 1.06 8.66) compared to the referent group only after adjusting for age, race, and traditional CHD risk factors. Patients with longer RA duration were more likely to have cumulative joint damage, manifested as prior joint surgery, joint deformity, and greater functional disability. Lower body mass index also was associated with longer RA duration.


CONCLUSIONS
Patients with longstanding RA have more extensive subclinical atherosclerosis or CAC compared to patients of the same age, independent of other CHD risk factors. RA duration may be a surrogate for factors related to the disease process or its treatment that may promote coronary atherogenesis.
Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. ahk7@pitt.edu
Amy H
AH
Kao
Shanthi
S
Krishnaswami
Amylynn
A
Cunningham
Daniel
D
Edmundowicz
Penelope A
PA
Morel
Lewis H
LH
Kuller
Mary Chester M
MC
Wasko
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002114:Calcinosis / Q000150:complications*; D009202:Cardiomyopathies / Q000150:complications*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications*; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012720:Severity of Illness Index; D013995:Time; D014057:Tomography, X-Ray Computed