Myocardial ischemia in female patients with rheumatoid arthritis assessed with single photon emission tomography-myocardial perfusion imaging

BACKGROUND: Non-specific cardiac symptoms in female patients with rheumatoid arthritis (RA) could indicate early cardiovascular disease. MATERIALS AND METHODS: Myocardial perfusion imaging (MPI), with 99mTc tetrofosmin stress–rest single photon emission computer tomography (SPECT), in 13 RA female patients with atypical cardiac symptoms, was compared to 44 weight- and age-matched females with similar cardiac complaints (control group). Smoking, hypertension, diabetes mellitus, dyslipidemia, obesity and cardiac heredity were recorded and compared between the study and control group. MPI was assessed using 17 segment polar map and with a scale of 0 to 5 scoring. RESULTS: Patients with RA demonstrated higher cardiovascular risk (46%) compared to control individuals (17%). In addition, patients with RA had more irreversible myocardial ischemic abnormalities in their MPI than the control group. Dyslipidemia and obesity was found more frequent in RA patients with MPI SSS ≥ 4. CONCLUSION: RA patients with atypical cardiac complaints are at higher risk for cardiovascular disease; early detection and monitoring of this patient group could potentially reverse or successfully manage the consequences of the upcoming cardiovascular disease.