Background Patients with RA have an excess risk of heart failure and related poor prognosis compared with the general population. The abnormal immunity and chronic inflammation in CVD and in RA share many common similarities. Some studies documented the worse left ventricular systolic and diastolic function in patients with RA 1,2. Acute coronary syndrome (ACS) is an urgent cardiovascular event, studies have shown a higher incidence myocardial infarction, congestive heart failure, and coronary deaths in patients with rheumatoid arthritis than in the general population. Our research investigated cardiac function in patients with ACS complicated with RA through analysis of laboratory parameters and echocardiogram measurements.
Objectives The aim of this study is to investigate the effects of rheumatoid arthritis on cardiac function in patients with ACS.
Methods 68 patients with ACS complicated with RA and 65 age- and sex-matched patients with ACS having no RA (controls) were enrolled; Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum high sensitivity C reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), homocysteine (HCY) and serum brain natriuretic peptide (BNP), were compared between two groups. Echocardiogram measurements were used to determine the changes of cardiac function.
Results Levels of BMI (27.91±4.12 Vs 24.87±3.58) were significantly higher in the ACS+RA patients than that in controls. No difference was observed in the levels of serum TG, TC and LDL-C, but HDL levels were significantly lower in ACS+RA patients (0.99±0.29 mmol/L) than that in controls (1.15±0.20mmol/L, P<0.05). Serum HCY (17.27±5.68) levels were significantly higher in ACS+RA group than that in controls (13.75±4.29). Serum hs-CRP levels (9.84±5.50 Vs 4.21±3.25 mg/L, P<0.01) and ESR levels (28.35±15.87 9.33±3.88 mm/1h, P<0.01) in the ACS+RA patients were significantly higher than that in controls, respectively (data not show). Level of BNP was significantly higher in patients in the ACS+RA group (386.74±225.88pg/ml) than control group (258.35±138.84 pg/ml) (Fig 1A). The LV ejection fraction % were significantly lower in ACS+RA patients (44.22±13.37%) than that in controls (61.34±10.45%, P<0.05) (Fig1B). Reduction of diastolic functions was found in 96.7% of ACS+RA patients and in 62.3% of control group (P<0.01) (Fig1C).
Conclusions Patients with ACS complicated with RA are more likely to be afflicted with reduction of left ventricular systolic and diastolic functions. Therefore, early intervention for controlling the inflammation of RA plays a significant role in preventing and alleviating the cardiac function changes in patients with ACS.
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Disclosure of Interest None declared