title: Inflammation and disease activity are associated with high circulating cardiac markers in rheumatoid arthritis independently of traditional cardiovascular risk factors.
abstract: OBJECTIVE
  To measure concentrations of high-sensitivity cardiac troponin (HS-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with rheumatoid arthritis (RA) and to examine correlates.
  
  
  METHODS
  The plasma concentrations of HS-cTnT and NT-proBNP were measured in consecutive patients with RA and compared to values obtained from age-matched and sex-matched healthy controls.
  
  
  RESULTS
  We included 236 unrelated patients with RA (192 females, 57 ± 13 yrs) and 213 controls (170 females, 55 ± 15 yrs). Seventy-one patients with RA were free of cardiovascular (CV) risk factors. HS-cTnT and NT-proBNP concentrations were significantly higher in the total cohort of patients with RA (p = 0.03 and p < 0.0001, respectively) and in the subgroup free of CV risk factors (p = 0.02 and p < 0.0001, respectively) compared to controls. In addition, both the total cohort of patients with RA and the subgroup free of CV risk factors were more likely to have levels above the cutoff concentrations of HS-cTnT (p = 0.003 and p = 0.007, respectively) and NT-proBNP (p = 0.0001 and p < 0.0001, respectively) than controls. Patients with RA and increased C-reactive protein (CRP) levels had higher HS-cTnT (p = 0.03) and NT-proBNP (p = 0.02) concentrations. HS-cTnT levels positively correlated with the 28-joint Disease Activity Score (DAS28-CRP; r = 0.2, p = 0.020). Multivariate logistic regression analysis indicated that increased HS-cTnT levels were independently associated with a DAS28-CRP > 5.1 (OR 11.8; 95% CI 1.6-35.5) and a body mass index > 30 kg/m(2) (OR 2.7; 95% CI 1.3-5.5).
  
  
  CONCLUSIONS
  HS-cTnT and NTproBNP are increased in patients with RA, independent of CV risk factors. The association between HS-cTnT, NT-proBNP, and CRP, together with the correlation between HS-cTnT and disease activity, support the link between myocardial injury/dysfunction and inflammation.
authors: From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Paris Descartes University, INSERM U1016 and CNRS UMR8104, Cochin Institute, Paris; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny; Clinical Chemistry Laboratory, Cochin and Hôtel-Dieu Hospitals; Paris 7 University, Rheumatology department, Bichat Claude Bernard Hospital; Clinical Chemistry and Hormonology Department, Tenon Hospital, Paris, France.
authors: Jérôme
authors: J
authors: Avouac
authors: Christophe
authors: C
authors: Meune
authors: Camille
authors: C
authors: Chenevier-Gobeaux
authors: Philippe
authors: P
authors: Dieudé
authors: Didier
authors: D
authors: Borderie
authors: Guillaume
authors: G
authors: Lefevre
authors: André
authors: A
authors: Kahan
authors: Yannick
authors: Y
authors: Allanore
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: BIOMARKER; CARDIOVASCULAR; HIGH-SENSITIVITY CARDIAC TROPONIN; MYOCARDIAL INJURY; N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE; RHEUMATOID ARTHRITIS