Patients with rheumatoid arthritis and systemic lupus erythematosus had higher coronary calcification scores than a control group when measured by CT in a study.
The prospective study, conducted in Hong Kong, included 154 patients (mean age, 49.2 years; 83.1% women) diagnosed with rheumatoid arthritis (RA) (n=85) and systemic lupus erythematosus (SLE) (n=69), plus 106 comparable disease-free controls. The mean duration of RA and SLE was 12.6 years.
All participants underwent multidetector computed tomography (MDCT), and their coronary calcification scores (CCS) were categorized according to range: 0, 1 to 10, 11 to 100 and greater than 100. The mean CCS of patients with RA and SLE were greater than those of controls (42.2 ± 154.3 vs. 1.4 ± 13.0, P<.01).
After a mean of 4.3 years of follow-up, researchers noted 10 major cardiovascular (CVS) events occurred in the RA/SLE group (five strokes, two nonfatal myocardial infarctions and three deaths) compared with none among the controls (P<.01). A greater rate of major CVS events occurred in RA/SLE patients with CCS of 1 to 10 (5%), 11 to 100 (14.3%) and greater than 100 (40%) than those who scored 0 (1.0%, P<.01).
Researchers cautioned that “the relatively low major CVS event rate in this young cohort of RA and SLE patients precludes the evaluation of a confident cut-off value for CCS in predicting future CVS events.”
Hypercholesterolemia (HR=11.16; 95% CI, 1.39-89.32) and CCS greater than 100 (HR=11.14; 95% CI, 1.31-95.0) were shown to be independent predictors of combined CVS events when researchers used multivariate Cox regression analysis to evaluate the impact of CCS results.
“The initial results indicated that CCS measured by MDCT is a clinically useful tool to improve risk stratification in patients with RA and SLE for early preventive measures, such as statin therapy to reduce CVS events in high-risk patients,” the researchers concluded.