Is Silent Ischemic Heart Disease Evident in Rheumatoid Arthritis Patients?

Background: Large number of studies have shown that individuals with rheumatoid arthritis (RA) are at increased risk for morbidity and mortality from ischaemic heart diseases (IHD) which accounts for almost half of all deaths in RA. Half of the RA patients with confirmed IHD had clinically silent disease. Therefore, early detection of Silent IHD can decrease the cardiovascular mortality in patients with rheumatoid arthritis. Objectives: To assess the incidence and identify the predictors of silent ischemic heart disease (SIHD) in patients with rheumatoid arthritis. Methods: One hundred eighty patients with rheumatoid arthritis with no history of IHD were studied. All patients subjected to full history taking and full clinical examination and investigated to fasting blood glucose, 2 hour post prandial blood glucose, serum creatinine, mean platelet volume, homocysteine level, urinary microalbuminuria, lipid profile RF, ESR, CRP, Resting ECG and stress ECG. RESULTS: Prevalence of silent ischemic heart disease in rheumatoid arthritis patients is 10.6%. Significantly increased incidence of SIHD among patients with rheumatoid arthritis with hypertension (27.9%), peripheral neuropathy (21.1%), microalbuminuria (56.7%) and family history of IHD (28.9%) (p value < 0.05). Important predictors for SIHD in RA patients were: increased body mass index, increased duration of rheumatoid arthritis, hypertension, increased mean platelet volume, hyperlipiemia, hyperhomocysteinaemia, and high CRP and RF titre. Conclusions: Silent IHD is a rather common incidence in rheumatoid arthritis patients (10.6 %). The predictors for SIHD are prolonged disease duration, hyperlipidemia, increased mean platelet volume, obesity, hypertension, hyperhomocysteinaemia and presence of activity markers. "Targeting these risk factors in RA patients could help in lowering incidence of ischemic heart disease and its complications". [Ashraf G. Dala, Waleed A. Ibrahim, Azza Ali Taha and Nevein M. Alsheikh. Is Silent Ischemic Heart Disease Evident in Rheumatoid Arthritis Patients? Life Sci J 2012; 9(3):927-934]. (ISSN:1097-8135). http://www.lifesciencesite.com. 132