title: Association of Chest Pain and Risk of Cardiovascular Disease with Coronary Atherosclerosis in Patients with Inflammatory Joint Diseases.
abstract: OBJECTIVE
  The relation between chest pain and coronary atherosclerosis (CA) in patients with inflammatory joint diseases (IJD) has not been explored previously. Our aim was to evaluate the associations of the presence of chest pain and the predicted 10-year risk of cardiovascular disease (CVD) by use of several CVD risk algorithms, with CA verified by multidetector computed tomography (MDCT) coronary angiography.
  
  
  METHODS
  Detailed information concerning chest pain and CVD risk factors was obtained in 335 patients with rheumatoid arthritis and ankylosing spondylitis. In addition, 119 of these patients underwent MDCT coronary angiography.
  
  
  RESULTS
  Thirty-one percent of the patients (104/335) reported chest pain. Only six patients (1.8%) had atypical angina pectoris (pricking pain at rest). In 69 patients without chest pain, two thirds had CA, while in those who reported chest pain (n = 50), CA was present in 48.0%. In a logistic regression analysis, chest pain was not associated with CA (dependent variable) (p = 0.43). About 30% (Nagelkerke R (2)) of CA was explained by any of the CVD risk calculators: Systematic Coronary Risk Evaluation, Framingham Risk Score, or Reynolds Risk Score.
  
  
  CONCLUSIONS
  The presence of chest pain was surprisingly infrequently reported in patients with IJD who were referred for a CVD risk evaluation. However, when present, chest pain was weakly associated with CA, in contrast to the predicted CVD risk by several risk calculators which was highly associated with the presence of CA. These findings suggest that clinicians treating patients with IJD should be alert of coronary atherosclerotic disease also in the absence of chest pain symptoms.
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rollefstad
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: Eirik
authors.initials: E
authors.lastname: Ikdahl
authors.affiliation: Section of Vascular Investigations, Oslo University Hospital Aker , Oslo , Norway.
authors.forename: Jonny
authors.initials: J
authors.lastname: Hisdal
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: Tore Kristian
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Centre of Preventive Medicine, Oslo University Hospital , Oslo , Norway ; Faculty of Medicine, University of Oslo , Oslo , Norway.
authors.forename: Terje Rolf
authors.initials: TR
authors.lastname: Pedersen
authors.affiliation: Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital , Oslo , Norway.
authors.forename: Anne Grete
authors.initials: AG
authors.lastname: Semb
keywords: atherosclerosis; cardiovascular diseases; chest pain; inflammatory joint diseases; risk factors