Coronary Microvascular Dysfunction in Rheumatoid Arthritis Compared to Diabetes Mellitus and Association With All‐Cause Mortality

Objective Coronary microvascular dysfunction (CMD) is a predictor of cardiac death in diabetes mellitus (DM) independent of traditional cardiovascular (CV) risk factors. Rheumatoid arthritis (RA) is a chronic inflammatory condition, with excess CV risk compared to the general population, in which CM...

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Published in:Arthritis care & research (2010) 2021-02, Vol.73 (2), p.159-165
Main Authors: Liao, Katherine P., Huang, Jie, He, Zeling, Cremone, Gabrielle, Lam, Ethan, Hainer, Jon M., Morgan, Victoria, Bibbo, Courtney, Di Carli, Marcelo
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - diagnosis
Arthritis, Rheumatoid - mortality
Cardiovascular diseases
Cause of Death
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - physiopathology
Coronary Circulation
Coronary Vessels - diagnostic imaging
Coronary Vessels - physiopathology
Diabetes
Diabetes mellitus
Diabetes Mellitus - diagnosis
Diabetes Mellitus - mortality
Female
Heart
Heart Disease Risk Factors
Humans
Inflammation
Male
Microcirculation
Microvasculature
Middle Aged
Mortality
Perfusion
Positron emission tomography
Prevalence
Prognosis
Registries
Retrospective Studies
Rheumatoid arthritis
Risk Assessment
Risk factors
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Summary:Objective Coronary microvascular dysfunction (CMD) is a predictor of cardiac death in diabetes mellitus (DM) independent of traditional cardiovascular (CV) risk factors. Rheumatoid arthritis (RA) is a chronic inflammatory condition, with excess CV risk compared to the general population, in which CMD is hypothesized to play a role; however, there are limited data on CMD in RA and any association with clinical outcomes. The objective of this study was to compare the prevalence of CMD in RA to that in DM and to test the association with all‐cause mortality. Methods We performed a retrospective cohort study using data from a registry of all patients undergoing stress myocardial perfusion positron emission tomography as part of routine clinical care from 2006 to 2017. The inclusion criterion was a normal perfusion scan. Patients with RA or DM were classified using previously published approaches. Coronary flow reserve (CFR) was calculated for all patients in the registry and linked with mortality data. CMD was defined as CFR
ISSN:2151-464X
2151-4658
DOI:10.1002/acr.24108