Relationship between hsTnI and coronary stenosis in asymptomatic women with rheumatoid arthritis.
BACKGROUND
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.


METHODS
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.


RESULTS
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 - 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 ≥ 0.49).


CONCLUSIONS
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.
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Milan
M
Hromádka
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic. seidlerovaji@fnplzen.cz.|Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic. seidlerovaji@fnplzen.cz.
Jitka
J
Seidlerová
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Jan
J
Baxa
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
David
D
Suchý
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Daniel
D
Rajdl
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Jakub
J
Šedivý
Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic.
Richard
R
Rokyta
Calcium score; Coronary CT angiography; Coronary heart disease; High-sensitivity troponin; Rheumatoid arthritis
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