Coronary artery disease in patients with rheumatoid arthritis is characterized by less extensive atherosclerosis but more inflammation and unstable atherosclerotic plaques than is coronary artery disease in arthritis-free matched controls, according to a first-of-its-kind autopsy study.
“We see less garden-variety CAD, with less multiple-vessel disease and a lower overall grade of stenosis,” Dr. Sherine E. Gabriel said at a symposium sponsored by the American College of Rheumatology.
Rheumatoid arthritis (RA) patients are known to have an increased risk of ischemic heart disease, compared with the general population. This elevated risk is present very early in the course of RA. In fact, by the time patients meet ACR criteria for a diagnosis of RA, they already have a several-fold greater prevalence of prior hospitalization for acute myocardial infarction and electrocardiogram evidence of silent MI than do matched controls, according to Dr. Gabriel, professor of medicine and epidemiology at the Mayo Clinic, Rochester, Minn.
The retrospective autopsy study was conducted by Dr. Gabriel and coinvestigators in the Rochester Epidemiology Project. It included 41 RA patients who died at a mean age of 79 years, 25 with known cardiovascular disease. They were matched by age, gender, and cardiovascular disease history to 82 non-RA controls.
http://www.rheumatologynews.com/article/S1541-9800(08)70083-8/fulltext
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