Cardiac troponin-I elevated in patients with rheumatoid arthritis

Cardiac-specific troponin-I concentrations, which may be indicative of myocardial injury despite the absence of heart failure diagnosis, were elevated in patients with rheumatoid arthritis in a recent study.

Researchers conducted a cross-sectional study that included 164 patients (mean age, 54 years; 68% women) with rheumatoid arthritis (RA) and 90 controls (mean age, 52.9 years; 62% women) without a history of heart failure. Thirteen percent of the RA group and 9% of controls had histories of cardiovascular disease (stroke, myocardial infarction angina) or a coronary procedure (bypass or angioplasty).

Using immunoassay analysis, high-sensitivity cardiac-specific troponin-I (cTn-I) concentrations were compared and found to be 49% greater in the RA group (median 1.15 pg/mL; IQR 0.73-1.92) than the control group (0.77 pg/mL; IQR 0.49-1.28) (P<.001). After adjustment for age, race and sex (P=.002); cardiovascular risk factors (P=.004), inflammatory markers (P=.008) and N-terminal pro-brain natriuretic peptide (P=.029) cTn-I levels remained higher in RA patients.

Correlations in patients with RA were established between cTn-I concentrations and age (rho=0.359), coronary artery calcium score (CACS) (rho=0.330) and systolic blood pressure (rho=0.248). Inflammation did not show a correlation with cTn-I levels. Researchers also observed a significant association between CACS and cTn-I in patients with RA (P<.001), but not upon multivariable adjustment for demographics and Framingham risk score (P=.79)

“High-sensitivity cTn-I concentrations are elevated in patients with RA without heart failure, independent of cardiovascular risk profile and inflammatory markers,” the researchers concluded. “Elevated troponin concentrations in RA may indicate subclinical, indolent myocardial injury.”

Disclosure: See the study for a full list of relevant disclosures.

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Source: Bradham WS. PloS One. 2012;7:e38930.