Calcification of coronary arteries in early rheumatoid arthritis prior to anti-rheumatic therapy

• Published in: Rheumatology international 2018-02, Vol.38 (2), p.211-217
• Main Authors: Udachkina, Helen V., Novikova, Diana S., Popkova, Tatiana V., Kirillova, Irina G., Markelova, Evgenia I., Luchikhina, Elena L., Lukina, Galina V., Sinitsyn, Valentin E., Karateev, Dmitry E., Nasonov, Eugeniy L.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Antirheumatic Agents - administration & dosage; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Atherosclerosis; Calcification; Clinical Trials as Topic; Comorbidities; Comorbidity; Computed Tomography Angiography; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Disease Progression; Female; Health risk assessment; Humans; Hypertension - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography; Predictive Value of Tests; Prevalence; Rheumatoid arthritis; Rheumatology; Risk Factors; Russia - epidemiology; Severity of Illness Index; Vascular Calcification - diagnostic imaging; Vascular Calcification - epidemiology
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-017-3860-9

Accelerated coronary atherosclerosis is common in patients with rheumatoid arthritis (RA). To examine coronary artery calcification (CAC) frequency and severity, its correlation with traditional risk factors (TRF) of cardiovascular diseases (CVD) and inflammatory markers in patients with early RA prior to anti-rheumatic therapy. RA adult patients (ACR/EULAR criteria, 2010, duration ≤ 12 months, without prior administration of disease-modifying anti-rheumatic drugs, glucocorticoids) underwent 32-row scanning for CAC scoring. Agatston, volume and mass calcium scores were calculated. Additionally, we used calculators on the website of the Multi-Ethnic Study of Atherosclerosis. 74 RA patients (women n  = 54 (73%), median age 56 years, median RA duration 6 months) with moderate/high RA activity (median DAS28 [ESR] 5.4) were enrolled within the framework of the observational study. Most of the patients had multiple TRFs of CVD and subclinical organ damage. CAC has been detected in 34 (46%) early RA patients. Calcification severity was significantly higher in men and in patients with ischemic heart disease (IHD). In patients younger than 45 years ( n  = 16) CAC was not detected. Among patients older than 45 years ( n  = 58), the frequency of CAC was 59%: asymptomatic patients— n  = 46 (48%), IHD patients— n  = 12 (100%). Among asymptomatic patients the presence of CAC associated with a significantly higher frequency of arterial hypertension (1.6 fold) compared with cases without CAC. Coronary age in asymptomatic patients with CAC and IHD patients was significantly greater than their actual age. More than half of early RA patients older 45 years had CAC. The presence and severity of CAC correlated positively with TRFs, but not with lipid levels and RA activity.