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Background: The term chronic inflammatory rheumatic diseases (CRID) define a group of rheumatic diseases, including rheumatoid arthritis and spondyloarthritis. Patients with CRID have a higher incidence of coronary heart disease than the general population as a result of a process of accelerated atherogenesis in these patients.
Objectives: To evaluate the extent of coronary vessel morphological damage observed in patients with CRID. To determine whether there is a characteristic coronary damage pattern in patients with CRID (cases) compared to those without CRID (controls).
Methods: Retrospective study of patients with CRID treated in the Rheumatology Service of the Hospital Fundación Jiménez Díaz who suffered a coronary event in the last five years (2018-2022). For this purpose, patients with CRID who underwent coronary angiography due to clinical indications where assessed. Two age- and sex-matched individuals with coronary artery disease, without inflammatory rheumatic diseases or without any other inflammatory or malignant condition, were used as controls for every patient with CRID.
Results: Forty-two of the 66 patients with CRID were women (63.6%), median age at the time of the coronary event 66.6 (range 58.3-75.2) years. When compared with matched controls we observed that the number of affected coronary arteries was higher in the CRID group compared to the controls (2.03 vs 1.56; p=0.03). Regarding coronary involvement, in the CRID group the mid anterior descending artery and right posterior descending artery were more commonly involved than in controls (OR 2.45 and 3.53, respectively; p ≤ 0.02 for both comparisons). Table 1 shows coronariographic differences between patients with CRID and matched controls.
Conclusion: When compared with matched controls, patients with CRID exhibit broader coronary damage and predisposition to involvement of mid anterior descending artery and right posterior descending artery.
Coronariographic differences between patients with CRID and matched controls.
| Coronary artery | Inflammatory disease* | Non-inflammatory disease** | Odds ratio (95% CI) | P | Area under the ROC curve (95% CI) |
|---|---|---|---|---|---|
| Left-heart dominant | 6/66 | 9/140 | 1.46 (0.41, 4.81) | 0.49 | 0.514 (0.473, 0.554) |
| Leftmaincoronaryartery | 6/65 | 18/140 | 0.69 (0.21, 1.94) | 0.45 | 0.482 (0.437, 0.527) |
| Proximalanterior descendingartery | 20/66 | 27/140 | 1.82 (0.87, 3.75) | 0.08 | 0.555 (0.490, 0.620) |
| Mid anterior descendingartery | 37/66 | 48/140 | 2.45 (1.29, 4.65) | 0.003 | 0.609 (0.537, 0.681) |
| Diagonalartery | 13/66 | 25/140 | 1.13 (0.49, 2.50) | 0.75 | 0.509 (0.451, 0.567) |
| Proximal circumflexartery | 10/66 | 24/140 | 0.86 (0.34 2.03) | 0.72 | 0.490 (0.436, 0.544) |
| Left marginal artery (obtuse) | 10/66 | 22/140 | 0.96 (0.38, 2.28) | 0.92 | 0.497 (0.444, 0.550) |
| Mid-distal circumflexartery | 7/66 | 12/140 | 1.27 (0.40, 3.69) | 0.64 | 0.510 (0.466, 0.554) |
| Proximal-mid right coronary artery | 27/66 | 49/140 | 1.29 (0.67, 2.44) | 0.41 | 0.530 (0.458, 0.601) |
| Right posterior descending | 9/66 | 6/140 | 3.53 (1.06, 12.5) | 0.02 | 0.547 (0.502, 0.592) |
| Posterolateral artery | 1/66 | 5/140 | 0.42 (0.01, 3.83) | 0.41 | 0.490 (0.468, 0.511) |
| Coronary calcification | 5/66 | 3/140 | 3.74 (0.70, 24.7) | 0.06 | 0.527 (0.493, 0.562) |
| Described thrombus | 1/66 | 6/140 | 0.34 (0.01, 2.93) | 0.31 | 0.486 (0.464, 0.509) |
| Coronary ectasia or aneurysm | 6/66 | 7/140 | 1.90 (0.50, 6.90) | 0.26 | 0.521 (0.481, 0.560) |
| Revascularization | 50/66 | 85/140 | 2.02 (1.01, 4.18) | 0.03 | 0.587 (0.517, 0.657) |
REFERENCES: NIL.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (