Cardiac Troponins Biomarker Predicts Cardiovascular Events in RA Patients

Researchers at the 2017 ACR/ARHP Annual Meeting found that a cardiac troponins biomarker predicted cardiovascular events in rheumatoid arthritis (RA) patients, even if they had no history of cardiovascular disease (CVD).

In there presentation, George A Karpouzas, MD, of the division of rheumatology at the Harbor-UCLA Medical Center, and colleagues explained that patients with RA typically have higher rates of CVD. They noted that this higher incidence rate may be explained by greater prevalence, severity, burden, and different composition of occult coronary atherosclerotic lesions in RA. As a result, they studied CVD biomarkers among RA patients to determine how this comorbidity could impact treatment.

“Cardiac troponins are specific biomarkers of myocardial injury; their measurement with highly-sensitive assays and at sub-threshold levels for myocardial infarction (MI) diagnosis, predicts greater risk of both fatal and non-fatal coronary heart disease, heart failure hospitalization, and overall mortality in the general population,” Dr Karpouzas and colleagues wrote.

The researchers studied 150 patients with RA without any prior diagnosis of CVD. They evaluated coronary plaque in order to determine cardiac troponins-I presence. They then measured for cardiovascular events 5 years after cardiac troponins-I detection.

Study results showed that 11 patients suffered cardiovascular events, of which eight were ischemic and included two cases of MI, two cases of stroke, two peripheral arterial ischemic events, and one fatal cardiovascular event. The researchers noted that the non-ischemic events were new onset, hospitalized, systolic heart failure.

Dr Karpouzas and colleagues found that cardiac troponins-I was higher in RA patients with cardiovascular events compared to those without cardiovascular events. They determined that patients with low cardiac troponins-I levels were 82% less likely to have a cardiovascular event.

“Highly-sensitive cardiac troponins-I may provide prognostic information on long-term cardiovascular event risk assessment in RA patients without symptoms or known history of CVD,” Dr Karpouzas and colleagues concluded.

—David Costill

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