Document Detail


Cardiovascular diseases in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  23244227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study cardiovascular autopsy findings and the lifetime prevalence of cardiovascular diseases (CVDs) in patients with rheumatoid arthritis (RA).
METHOD: In 369 RA patients and their reference cases without any rheumatic disease (non-RA), we studied CVDs recorded on autopsy reports at consecutive autopsies from 1952 to 1991. From autopsy referrals by clinicians, we recorded lifetime CVDs. In RA patients autopsied from 1973, we evaluated clinical data.
RESULTS: From 1952 to 1991, RA patients had, compared with non-RA, myocardial infarction (MI; 26% vs. 41%) and cerebral infarction (14% vs. 28%) less frequently but cardiac amyloidosis (28% vs. 3%), pericarditis (27% vs. 8%), and diffuse myocardial abnormality (21% vs. 11%) more frequently reported at autopsy. Of RA patients autopsied from 1973, 40% had had a diagnosis of congestive heart failure (CHF) and coronary heart disease (CHD) during their lifetime. The RA patients with CHF had a higher mean erythrocyte sedimentation rate (ESR) than those without CHF. In RA patients, MI or myocardial abnormality at autopsy had no such correlation. In RA, male sex, ischaemic electrocardiogram changes, diabetes, hypertensive disease, and severe radiographic changes typical for RA were associated with MI detected at autopsy. No such associations emerged with respect to diffuse myocardial abnormality. When disorders potentially causing diffuse myocardial damage were excluded, RA patients had, on autopsy reports, compared to non-RA, diffuse myocardial abnormality more frequently (21% vs. 12%, p = 0.002). Cardiac amyloidosis showed no correlation to this.
CONCLUSION: RA patients seem to have an increased risk for myocardial damage. The influence of inflammation on the myocardium in RA needs further studies.
Authors:
R Koivuniemi; L Paimela; R Suomalainen; M Leirisalo-Repo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-12-18
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  42     ISSN:  1502-7732     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-27     Completed Date:  2013-05-16     Revised Date:  2013-11-01    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, Helsinki, Finland. riitta.koivuniemi@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Aged
Amyloidosis
Arthritis, Rheumatoid / complications*
Autopsy
Cardiovascular Diseases / etiology*
Case-Control Studies
Coronary Disease / etiology*
Female
Humans
Male
Middle Aged
Myocardial Infarction / etiology*
Prevalence
Registries
Comments/Corrections
Comment In:
Scand J Rheumatol. 2013;42(5):422-3   [PMID:  23848174 ]
Scand J Rheumatol. 2013;42(5):423-4   [PMID:  23848941 ]

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