Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study
Identifieur interne : 001427 ( Istex/Corpus ); précédent : 001426; suivant : 001428Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study
Auteurs : N. Hanim Ma ; C. L. Teh ; A. Rapaee ; K. B. Lau ; Alan Y. Y. Fong ; Sithy Hi ; B. C. Chang ; K. L. Yew ; H. B. Liew ; C. K. Ang ; T. K. Ong ; S. K. Chua ; Rowland W. M. Chin ; K. H. SimSource :
- International Journal of Rheumatic Diseases [ 1756-1841 ] ; 2010-08.
Abstract
Introduction: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population. Objective: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients. Methods: We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP. Results: There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients. Conclusions: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.
Url:
DOI: 10.1111/j.1756-185X.2010.01533.x
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Lau</name><affiliation><mods:affiliation>Pathology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Fong, Alan Y Y" sort="Fong, Alan Y Y" uniqKey="Fong A" first="Alan Y. Y." last="Fong">Alan Y. Y. Fong</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Hi, Sithy" sort="Hi, Sithy" uniqKey="Hi S" first="Sithy" last="Hi">Sithy Hi</name><affiliation><mods:affiliation>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia</mods:affiliation></affiliation></author><author><name sortKey="Chang, B C" sort="Chang, B C" uniqKey="Chang B" first="B. C." last="Chang">B. C. Chang</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Yew, K L" sort="Yew, K L" uniqKey="Yew K" first="K. L." last="Yew">K. L. 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Hanim Ma</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Teh, C L" sort="Teh, C L" uniqKey="Teh C" first="C. L." last="Teh">C. L. Teh</name><affiliation><mods:affiliation>Rheumatology Unit, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Rapaee, A" sort="Rapaee, A" uniqKey="Rapaee A" first="A." last="Rapaee">A. Rapaee</name><affiliation><mods:affiliation>Universiti Malaysia Sarawak</mods:affiliation></affiliation></author><author><name sortKey="Lau, K B" sort="Lau, K B" uniqKey="Lau K" first="K. B." last="Lau">K. B. Lau</name><affiliation><mods:affiliation>Pathology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Fong, Alan Y Y" sort="Fong, Alan Y Y" uniqKey="Fong A" first="Alan Y. Y." last="Fong">Alan Y. Y. Fong</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Hi, Sithy" sort="Hi, Sithy" uniqKey="Hi S" first="Sithy" last="Hi">Sithy Hi</name><affiliation><mods:affiliation>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia</mods:affiliation></affiliation></author><author><name sortKey="Chang, B C" sort="Chang, B C" uniqKey="Chang B" first="B. C." last="Chang">B. C. Chang</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Yew, K L" sort="Yew, K L" uniqKey="Yew K" first="K. L." last="Yew">K. L. Yew</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Liew, H B" sort="Liew, H B" uniqKey="Liew H" first="H. B." last="Liew">H. B. Liew</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Ang, C K" sort="Ang, C K" uniqKey="Ang C" first="C. K." last="Ang">C. K. Ang</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Ong, T K" sort="Ong, T K" uniqKey="Ong T" first="T. K." last="Ong">T. K. Ong</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Chua, S K" sort="Chua, S K" uniqKey="Chua S" first="S. K." last="Chua">S. K. Chua</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Chin, Rowland W M" sort="Chin, Rowland W M" uniqKey="Chin R" first="Rowland W. M." last="Chin">Rowland W. M. Chin</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author><author><name sortKey="Sim, K H" sort="Sim, K H" uniqKey="Sim K" first="K. H." last="Sim">K. H. Sim</name><affiliation><mods:affiliation>Cardiology Department, Sarawak General Hospital</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">International Journal of Rheumatic Diseases</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES</title><idno type="ISSN">1756-1841</idno><idno type="eISSN">1756-185X</idno><imprint><biblScope unit="vol">13</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="223">223</biblScope><biblScope unit="page" to="229">229</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-08">2010-08</date></imprint><idno type="ISSN">1756-1841</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1756-1841</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Introduction: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population. Objective: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients. Methods: We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP. Results: There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients. Conclusions: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>mdct</json:string><json:string>rheumatoid</json:string><json:string>rheumatoid arthritis</json:string><json:string>remission</json:string><json:string>subclinical</json:string><json:string>cardiovascular</json:string><json:string>hscrp</json:string><json:string>sarawak</json:string><json:string>atherosclerosis</json:string><json:string>atherosclerotic</json:string><json:string>arterial stiffness</json:string><json:string>methotrexate</json:string><json:string>subclinical atherosclerosis</json:string><json:string>tomography</json:string><json:string>international journal</json:string><json:string>rheumatic disease</json:string><json:string>sarawak general hospital</json:string><json:string>current study</json:string><json:string>arthritis rheum</json:string><json:string>inflammation</json:string><json:string>stiffness</json:string><json:string>arthritis</json:string><json:string>cardiovascular event</json:string><json:string>pilot study</json:string><json:string>independent risk factor</json:string><json:string>median</json:string><json:string>comparative study</json:string><json:string>cardiovascular disease</json:string><json:string>disease duration</json:string><json:string>control patient</json:string><json:string>natriuretic peptide</json:string><json:string>risk factor</json:string><json:string>pulse wave velocity</json:string><json:string>calcification</json:string><json:string>rheum</json:string><json:string>control group</json:string><json:string>atherosclerotic burden</json:string><json:string>cardiovascular risk</json:string><json:string>coronary artery disease</json:string><json:string>small sample size</json:string><json:string>larger study</json:string><json:string>systemic inflammation</json:string><json:string>atherosclerotic plaque</json:string><json:string>cardiovascular mortality</json:string><json:string>subclinical coronary artery disease</json:string><json:string>possible mechanism</json:string><json:string>other marker</json:string><json:string>family history</json:string><json:string>negative predictive value</json:string><json:string>visual estimate</json:string><json:string>year experience</json:string><json:string>quantitative datum</json:string><json:string>demographic profile</json:string><json:string>interquartile range</json:string><json:string>ventricular dysfunction</json:string><json:string>cardiovascular death</json:string><json:string>triple therapy</json:string><json:string>calcium score</json:string><json:string>diabetes mellitus</json:string><json:string>atypical chest pain</json:string><json:string>premature death</json:string><json:string>myocardial infarction</json:string><json:string>significant correlation</json:string><json:string>significant association</json:string><json:string>first study</json:string><json:string>acute myocardial infarction</json:string><json:string>british patient</json:string><json:string>cardiovascular risk factor</json:string><json:string>median disease duration</json:string><json:string>coll cardiol</json:string><json:string>rheumatic</json:string></teeft></keywords><author><json:item><name>N. Hanim MA</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>C.L. TEH</name><affiliations><json:string>Rheumatology Unit, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>A. RAPAEE</name><affiliations><json:string>Universiti Malaysia Sarawak</json:string></affiliations></json:item><json:item><name>K.B. LAU</name><affiliations><json:string>Pathology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>Alan Y.Y. FONG</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>Sithy HI</name><affiliations><json:string>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia</json:string></affiliations></json:item><json:item><name>B.C. CHANG</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>K.L. YEW</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>H.B. LIEW</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>C.K. ANG</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>T.K. ONG</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>S.K. CHUA</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>Rowland W.M. CHIN</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item><json:item><name>K.H. SIM</name><affiliations><json:string>Cardiology Department, Sarawak General Hospital</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>CAD</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MDCT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rheumatoid arthritis</value></json:item></subject><articleId><json:string>APL1533</json:string></articleId><arkIstex>ark:/67375/WNG-C8XW1W8Q-B</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Introduction: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population. Objective: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients. Methods: We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP. Results: There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients. Conclusions: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.</abstract><qualityIndicators><score>9.068</score><pdfWordCount>4068</pdfWordCount><pdfCharCount>25524</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>7</pdfPageCount><pdfPageSize>595.276 x 779.528 pts</pdfPageSize><pdfWordsPerPage>581</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>292</abstractWordCount><abstractCharCount>1869</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title><pmid><json:string>20704618</json:string></pmid><genre><json:string>article</json:string></genre><host><title>International Journal of Rheumatic Diseases</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1756-185X</json:string></doi><issn><json:string>1756-1841</json:string></issn><eissn><json:string>1756-185X</json:string></eissn><publisherId><json:string>APL</json:string></publisherId><volume>13</volume><issue>3</issue><pages><first>223</first><last>229</last><total>7</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Original articles</value></json:item><json:item><value>ORIGINAL ARTICLE</value></json:item></subject></host><namedEntities><unitex><date><json:string>from November 2008 to February 2009</json:string><json:string>2010</json:string></date><geogName></geogName><orgName><json:string>Blackwell Publishing Asia Pty Ltd</json:string><json:string>SPSS Inc., Chicago</json:string><json:string>Pathology Department, Sarawak General Hospital</json:string><json:string>ACR</json:string><json:string>Sarawak General Hospital, Malaysia</json:string><json:string>Department of Medicine, Sarawak General Hospital, Jalan Hospital</json:string><json:string>American College of Rheumatology</json:string><json:string>Universiti Malaysia Sarawak</json:string><json:string>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia Abstract Introduction</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Asia Paci</json:string><json:string>Iban Bidayuh</json:string></persName><placeName><json:string>Malaysia</json:string><json:string>Hong Kong</json:string><json:string>Kuala Lumpur</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Booth et al.</json:string><json:string>Khera et al.</json:string><json:string>Solus et al.</json:string><json:string>N. H. Ma et al.</json:string><json:string>Ridker et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-C8XW1W8Q-B</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - rheumatology</json:string></wos><scienceMetrix></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Rheumatology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1111/j.1756-185X.2010.01533.x</json:string></doi><id>B175FCD0E1F3E6171401A1B8DE8E688D2F34367A</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-C8XW1W8Q-B/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-C8XW1W8Q-B/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-C8XW1W8Q-B/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title><title level="a" type="short">Subclinical coronary artery disease in Asian RA</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 2010 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd</licence></availability><date type="published" when="2010-08"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title><title level="a" type="short">Subclinical coronary artery disease in Asian RA</title><author xml:id="author-0000"><persName><forename type="first">N. Hanim</forename><surname>MA</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0001"><persName><forename type="first">C.L.</forename><surname>TEH</surname></persName><affiliation><orgName type="laboratory">Rheumatology Unit</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0002"><persName><forename type="first">A.</forename><surname>RAPAEE</surname></persName><affiliation><orgName type="institution">Universiti Malaysia Sarawak</orgName></affiliation></author><author xml:id="author-0003"><persName><forename type="first">K.B.</forename><surname>LAU</surname></persName><affiliation><orgName type="division">Pathology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Alan Y.Y.</forename><surname>FONG</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Sithy</forename><surname>HI</surname></persName><affiliation><orgName type="institution">Clinical Research Center</orgName><orgName type="institution">Sarawak General Hospital</orgName><address><addrLine>Sarawak</addrLine><addrLine>Malaysia</addrLine><country key="MY" xml:lang="en">MALAYSIA</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">B.C.</forename><surname>CHANG</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0007"><persName><forename type="first">K.L.</forename><surname>YEW</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0008"><persName><forename type="first">H.B.</forename><surname>LIEW</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0009"><persName><forename type="first">C.K.</forename><surname>ANG</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0010"><persName><forename type="first">T.K.</forename><surname>ONG</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0011"><persName><forename type="first">S.K.</forename><surname>CHUA</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0012"><persName><forename type="first">Rowland W.M.</forename><surname>CHIN</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><author xml:id="author-0013"><persName><forename type="first">K.H.</forename><surname>SIM</surname></persName><affiliation><orgName type="division">Cardiology Department</orgName><orgName type="institution">Sarawak General Hospital</orgName></affiliation></author><idno type="istex">B175FCD0E1F3E6171401A1B8DE8E688D2F34367A</idno><idno type="ark">ark:/67375/WNG-C8XW1W8Q-B</idno><idno type="DOI">10.1111/j.1756-185X.2010.01533.x</idno><idno type="unit">APL1533</idno><idno type="toTypesetVersion">file:APL.APL1533.pdf</idno></analytic><monogr><title level="j" type="main">International Journal of Rheumatic Diseases</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES</title><idno type="pISSN">1756-1841</idno><idno type="eISSN">1756-185X</idno><idno type="book-DOI">10.1111/(ISSN)1756-185X</idno><idno type="book-part-DOI">10.1111/apl.2010.13.issue-3</idno><idno type="product">APL</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">13</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="223">223</biblScope><biblScope unit="page" to="229">229</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-08"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><p><hi rend="bold">Introduction: </hi> Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population.</p><p><hi rend="bold">Objective: </hi> The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients.</p><p><hi rend="bold">Methods: </hi> We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP.</p><p><hi rend="bold">Results: </hi> There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (<hi rend="italic">P </hi>=<hi rend="italic"> </hi>0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients.</p><p><hi rend="bold">Conclusions: </hi> In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">CAD</term><term xml:id="k2">MDCT</term><term xml:id="k3">rheumatoid arthritis</term></keywords><keywords rend="tocHeading1"><term>Original articles</term></keywords><keywords rend="articleCategory"><term>ORIGINAL ARTICLE</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-C8XW1W8Q-B/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1756-185X</doi><issn type="print">1756-1841</issn><issn type="electronic">1756-185X</issn><idGroup><id type="product" value="APL"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES">International Journal of Rheumatic Diseases</title></titleGroup></publicationMeta><publicationMeta level="part" position="08103"><doi origin="wiley">10.1111/apl.2010.13.issue-3</doi><numberingGroup><numbering type="journalVolume" number="13">13</numbering><numbering type="journalIssue" number="3">3</numbering></numberingGroup><coverDate startDate="2010-08">August 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="6" status="forIssue"><doi origin="wiley">10.1111/j.1756-185X.2010.01533.x</doi><idGroup><id type="unit" value="APL1533"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">Original articles</title><title type="articleCategory">ORIGINAL ARTICLE</title></titleGroup><copyright>© 2010 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd</copyright><eventGroup><event type="firstOnline" date="2010-06-10"></event><event type="publishedOnlineFinalForm" date="2010-08-03"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-06-10"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.2.0 mode:FullText" date="2013-03-28"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-04"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-23"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="223">223</numbering><numbering type="pageLast" number="229">229</numbering></numberingGroup><correspondenceTo>Dr C. L. Teh, Unit of Rheumatology, Department of Medicine, Sarawak General Hospital, Jalan Hospital, 93450 Kuching, Sarawak, Malaysia. Email: <email>tehchenglay@yahoo.com</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:APL.APL1533.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="3"></count></countGroup><titleGroup><title type="main">Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title><title type="shortAuthors">N. H. Ma <i>et al.</i></title><title type="short">Subclinical coronary artery disease in Asian RA</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>N. Hanim</givenNames><familyName>MA</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>C.L.</givenNames><familyName>TEH</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>A.</givenNames><familyName>RAPAEE</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a4"><personName><givenNames>K.B.</givenNames><familyName>LAU</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>Alan Y.Y.</givenNames><familyName>FONG</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a5"><personName><givenNames>Sithy</givenNames><familyName>HI</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>B.C.</givenNames><familyName>CHANG</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>K.L.</givenNames><familyName>YEW</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a1"><personName><givenNames>H.B.</givenNames><familyName>LIEW</familyName></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a1"><personName><givenNames>C.K.</givenNames><familyName>ANG</familyName></personName></creator><creator creatorRole="author" xml:id="cr11" affiliationRef="#a1"><personName><givenNames>T.K.</givenNames><familyName>ONG</familyName></personName></creator><creator creatorRole="author" xml:id="cr12" affiliationRef="#a1"><personName><givenNames>S.K.</givenNames><familyName>CHUA</familyName></personName></creator><creator creatorRole="author" xml:id="cr13" affiliationRef="#a1"><personName><givenNames>Rowland W.M.</givenNames><familyName>CHIN</familyName></personName></creator><creator creatorRole="author" xml:id="cr14" affiliationRef="#a1"><personName><givenNames>K.H.</givenNames><familyName>SIM</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Cardiology Department, Sarawak General Hospital</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Rheumatology Unit, Sarawak General Hospital</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="MY"><unparsedAffiliation>Universiti Malaysia Sarawak</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Pathology Department, Sarawak General Hospital</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="MY"><unparsedAffiliation>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">CAD</keyword><keyword xml:id="k2">MDCT</keyword><keyword xml:id="k3">rheumatoid arthritis</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Introduction: </b> Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population.</p><p><b>Objective: </b> The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients.</p><p><b>Methods: </b> We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP.</p><p><b>Results: </b> There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (<i>P </i>=<i> </i>0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients.</p><p><b>Conclusions: </b> In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Subclinical coronary artery disease in Asian RA</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study</title></titleInfo><name type="personal"><namePart type="given">N. Hanim</namePart><namePart type="family">MA</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.L.</namePart><namePart type="family">TEH</namePart><affiliation>Rheumatology Unit, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">RAPAEE</namePart><affiliation>Universiti Malaysia Sarawak</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.B.</namePart><namePart type="family">LAU</namePart><affiliation>Pathology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alan Y.Y.</namePart><namePart type="family">FONG</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sithy</namePart><namePart type="family">HI</namePart><affiliation>Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.C.</namePart><namePart type="family">CHANG</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.L.</namePart><namePart type="family">YEW</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H.B.</namePart><namePart type="family">LIEW</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.K.</namePart><namePart type="family">ANG</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T.K.</namePart><namePart type="family">ONG</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.K.</namePart><namePart type="family">CHUA</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rowland W.M.</namePart><namePart type="family">CHIN</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.H.</namePart><namePart type="family">SIM</namePart><affiliation>Cardiology Department, Sarawak General Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-08</dateIssued><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">0</extent><extent unit="tables">3</extent></physicalDescription><abstract lang="en">Introduction: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population. Objective: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi‐detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐senstivity C‐reactive protein (hs‐CRP) to detect subclinical atherosclerosis in RA patients. Methods: We performed a comparative cross‐sectional study of 47 RA patients who were in remission with a control group of non‐RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64‐slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT‐proBNP and hsCRP. Results: There were 94 patients in our study with a mean age of 50 ± 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients. Conclusions: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.</abstract><subject lang="en"><genre>keywords</genre><topic>CAD</topic><topic>MDCT</topic><topic>rheumatoid arthritis</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Rheumatic Diseases</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Original articles</topic><topic>ORIGINAL ARTICLE</topic></subject><identifier type="ISSN">1756-1841</identifier><identifier type="eISSN">1756-185X</identifier><identifier type="DOI">10.1111/(ISSN)1756-185X</identifier><identifier type="PublisherID">APL</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>13</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>223</start><end>229</end><total>7</total></extent></part></relatedItem><relatedItem type="references" displayLabel="cit1"><titleInfo><title>Economic burden of rheumatoid arthritis: a systematic review</title></titleInfo><name type="personal"><namePart type="given">NJ</namePart><namePart type="family">Cooper</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Cooper NJ (2000) Economic burden of rheumatoid arthritis: a systematic review. Rheumatology (Oxford) 39, 28–33.</note><part><date>2000</date><detail type="volume"><caption>vol.</caption><number>39</number></detail><extent unit="pages"><start>28</start><end>33</end></extent></part><relatedItem type="host"><titleInfo><title>Rheumatology (Oxford)</title></titleInfo><part><date>2000</date><detail type="volume"><caption>vol.</caption><number>39</number></detail><extent unit="pages"><start>28</start><end>33</end></extent></part></relatedItem></relatedItem><relatedItem type="references" displayLabel="cit2"><titleInfo><title>Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta‐analysis of observational studies</title></titleInfo><name type="personal"><namePart type="given">JA</namePart><namePart type="family">Aviña‐Zubieta</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">HK</namePart><namePart type="family">Choi</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Sadatsafavi</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Aviña‐Zubieta JA, Choi HK, Sadatsafavi M, et al. (2008) Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta‐analysis of observational studies. Arthritis Rheum 59, 1690–7.</note><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>59</number></detail><extent unit="pages"><start>1690</start><end>7</end></extent></part><relatedItem type="host"><titleInfo><title>Arthritis Rheum</title></titleInfo><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>59</number></detail><extent unit="pages"><start>1690</start><end>7</end></extent></part></relatedItem></relatedItem><relatedItem type="references" displayLabel="cit3"><titleInfo><title>Survival in rheumatoid arthritis: a population‐based analysis of trends over 40 years</title></titleInfo><name type="personal"><namePart type="given">SE</namePart><namePart type="family">Gabriel</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CS</namePart><namePart type="family">Crowson</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">KremersH</namePart><namePart type="family">Maradit</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Gabriel SE, Crowson CS, Maradit KremersH, et al. (2003) Survival in rheumatoid arthritis: a population‐based analysis of trends over 40 years. 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