The aim was to detect specific ECG changes in rheumatoid arthritis (RA) patients as
well as to study atherosclerotic changes of the carotid arteries as an indicator of
cardiovascular system risk factors and to correlate findings with disease activity and
severity parameters to elucidate possible associations between these variables.
Patients and methods
This study included 30 RA patients, 30 age-matched and sex-matched systemic
lupus erythematosus patients and 30 age-matched and sex-matched healthy
volunteers as control groups. The patients were subjected to clinical
examination, assessment of disease activity score-28 (DAS28), functional
disability Health Assessment Questionnaire, and laboratory and radiological
assessments. ECG and measurement of the carotid intima media thickness
(CIMT) by carotid ultrasound scan was also done.
Results
Ten (33.3%) RA patients had ECG abnormalities, with ST or T-wave abnormality
being the most common abnormality present. RA patients had the highest
frequencies of ECG abnormalities. Most ECG changes occurred in RA patients
using steroids (90%). ST or T-wave abnormality in RA occurred more in patients
with a higher swollen joint count, higher DAS28, and a higher patients’ global health
assessment. RA patients had the highest mean. The mean CIMT was significantly
higher in RA patients with ECG abnormalities. There were significant positive
correlations of average CIMT with DAS28, Health Assessment Questionnaire, and
Simple Erosion Narrowing Score. There were significant positive correlations of
mean CIMT with the level of triglycerides, cholesterol, high-density lipoprotein,
erythrocyte sedimentation rate, and a highly significant correlation between mean
CIMT and C-reactive protein. CIMT at a cut-off point of 0.75mm can predict ECG
abnormalities with high sensitivity and specificity.
Conclusion
ECG changes were present in 33.3% of RA patients. Increased CIMT was observed
in RA patients and correlated well with disease activity and severity parameters |
