CVD & Cardiac Outcomes
Isabel M. McFarlane, MD, FACP, is a clinical assistant professor in the Department of Medicine at SUNY Medical Center, Brooklyn, N.Y. She believes this study is important because it sheds new light on the association of coronary microvascular dysfunction with cardiac outcome in RA.
“It has long been recognized that RA patients have 1.5-fold increase in CV events compared with the general population and [that] risk is similar to the diabetic population,” she says. “This study provides new supporting evidence that impaired coronary flow reserve detected in normal perfusion scans can hint at a higher risk for all-cause mortality and fatal cardiac events among RA patients.”
Systemic inflammation with endothelial cell activation and cytokine expression are crucial to development of atherosclerosis. This, in turn, leads to the increased risk in cardiac events seen among RA patients.
“This study is likely to have important implications for the practicing physician in the assessment of myocardial blood flow, particularly with a readily available assessment tool,” says Dr. McFarlane. “Cardiac perfusion PET scans calculate coronary flow reserve, a surrogate for cardiac microvascular dysfunction, that physicians can use to implement aggressive therapeutic interventions aiming to control inflammation in RA and educate patients in better management of CV risk factors.”
Kurt Ullman is a freelance writer based in Indiana.
Reference
- Liao KP, Huang J, He Z, et al. Coronary microvascular dysfunction in rheumatoid arthritis compared to diabetes mellitus and association with all-cause mortality. Arthritis Care Res (Hoboken). 2019 Nov 9;10.1002/acr.24108. [Online ahead of print]
