Author/Authors :
ABO-ELNOR, EL-BADRY I. Assiut University - Faculty of Medicine - Department of Internal Medicine, Egypt , ARGOON, SALAH A.A.S. Assiut University - Faculty of Medicine - Department of Internal Medicine, Egypt , ABD ELMONEIM, OMNIYA Assiut University - Faculty of Medicine - Department of Clinical Pathology, Egypt , SELIM, AYMEN M. Assiut University - Faculty of Medicine - Department of Radiology, Egypt , HASHEM, NORA Assiut University - Faculty of Medicine - Department of Internal Medicine, Egypt
Abstract :
Objective: The study aims to evaluate some cardiovascular risk factors in patients with rheumatoid arthritis (RA) and their relationship to ischemic heart disease (IHD) and atherosclerosis. Patients and Methods: The study included fifty patients with RA and twenty-five healthy controls. All patients and controls were subjected to full history taking, clinical examination and the following investigations: ECG, echocardiography, carotid Doppler ultrasonography, complete blood count, rheumatoid factor (RF), C-reactive protein (CRP), serum homocysteine, serum prolactin, serum uric acid, and lipid profile (total cholesterol, triglycerides (TG), HDL-C, LDL-C). Results: The group of RA patients had significant higher number of patients with positive CRP, with high serum uric acid, higher mean serum homocysteine, higher mean serum prolactin, higher mean total cholesterol, higher mean TG, higher mean LDL-C and lower mean HDL-C levels than the control group. Also, the group of RA patients had significant higher number of patients with ischemic changes in both ECG and echocardiography, with carotid atheromatous plaques, and significant higher mean right and left carotid intimamedia thickness (IMT) than the control group. In RA patients, there were significant positive correlations between the ischemic changes in both ECG and echocardiography, carotid IMT and carotid atheromatous plaques and all the following risk factors; serum CRP, serum uric acid, serum homocysteine, serum prolactin, serum total cholesterol, serum TG, serum LDL-C levels and prolonged disease duration. Conclusion: IHD and atherosclerosis are common in RA patients. The risk factors for IHD are hyperlipidemia, hyper-homocysteinaemia, hyperprolactinemia, hyperuricemia, elevated inflammatory markers such as CRP, and prolonged disease duration. Targeting these risk factors in RA patients could help in lowering incidence of IHD and its sequelae. We recommend ECG, echocardiography and carotid Doppler ultrasonography as non-invasive screening tests for early detection of IHD and atherosclerosis in RA patients.
