The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Patient Characteristics
3.2. Cardiac Function at Baseline
3.3. Disease Activity and Cardiac Function at six Months Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Patient Characteristics | n = 47 |
---|---|
Age, years | 57 (±11) |
Gender, female (n, %) | 32 (68%) |
RA disease duration, years | 5 (2–19) |
BMI, kg/m2 | 26.0 (±4.5) |
History of vascular disease (n, %) | 1 (2%) |
Hypertension (n, %) | 4 (9%) |
Systolic blood pressure, mmHg | 130 (±15) |
Diastolic blood pressure, mmHg | 80 (±10) |
Hypercholesterolemia (n, %) | 3 (6%) |
Diabetes mellitus type 2 (n, %) | 1 (2%) |
Smoking (n, %) | 13 (29%) |
Rheumatoid factor positive (n, %) | 33 (66%) |
Anti-cyclic citrullinated protein positive (n, %) | 32 (68%) |
LDL, mmol/L | 2.93 (±0.90) |
HDL, mmol/L | 1.57 (±0.50) |
Medication | |
Current oral corticosteroid use (n, %) | 13 (28%) |
Intra-muscular/intra-articular corticosteroid in the past 3 months (n, %) | 9 (19%) |
csDMARD use | 43 (92%) |
Methotrexate (with or without other csDMARD(s)) | 33 (70%) |
Other csDMARD(s) | 10 (21%) |
Biological therapy (n, %) | |
Etanercept | 16 (34%) |
Adalimumab | 23 (49%) |
Certolizumab | 7 (15%) |
Golimumab | 1 (2%) |
Disease activity parameters | |
DAS28 | 4.44 (±1.23) |
CRP, mmol/L | 6.3 (3.1–20.0) |
ESR, mm/h | 22.5 (9.0–42.5) |
Health assessment questionnaire (HAQ) | 1.25 (0.75–1.50) |
Cardiac parameters | |
E/e’ ratio (n = 46) | 7.9 (6.6–9.0) |
E/A ratio (n = 46) | 1.1 (±0.36) |
Deceleration time, ms (n = 43) | 0.22 (±0.06) |
LA volume index, mL/m2 (n = 33) | 28.40 (±7.53) |
LV ejection fraction, % (n = 29) | 63.1 (±8.8) |
GLS (n = 44) | −19.8 (±3.5) |
Impaired GLS (>−17%) (n, %) (n = 44) | 6 (14%) |
LV mass index, g/m2 (n = 42) | 68.46 (±17.97) |
Diastolic LV dysfunction (n, %) (n = 46) | |
No diastolic dysfunction | 38 (83%) |
grade I | 2 (4%) |
grade II | 1 (2%) |
grade III | 0 (0%) |
indeterminate | 5 (11%) |
Systolic LV dysfunction (n, %) (n = 29) | 2 (7%) |
Aortic valve stenosis (n, %) (n = 46) | 0 (0%) |
Aortic valve regurgitation (n, %) (n=46) | 6 (13%) |
mild | 6 (13%) |
moderate | 0 (0%) |
severe | 0 (0%) |
Mitral valve stenosis (n, %) (n = 46) | 0 (0%) |
Mitral valve regurgitation (n, %) (n = 45) | 18 (38%) |
mild | 18 (38%) |
moderate | 0 (%) |
severe | 0 (0%) |
H2FPEF score | |
0–1 points | 32 (70%) |
2–4 points | 15 (30%) |
5–6 points | 0 (0%) |
Cardiac biomarkers | |
Troponin-T, µg/mL | 6 (3–8) |
NT-proBNP, ng/L | 88.6 (47.0–142.0) |
Baseline (n = 47) | Follow-Up (n = 33) | p-Value | |
---|---|---|---|
Cardiac parameters | |||
E/e’ | 7.9 (6.6–9.0) | 7.7 (7.1–9.1) | 0.17 |
E/A | 1.1 (±0.4) | 1.1 (±0.4) | 0.94 |
Deceleration time, sec | 0.22 (±0.06) | 0.22 (±0.04) | 0.44 |
LA volume index, mL/m2 | 28.4 (±7.5) | 30.3 (±5.4) | 0.21 |
LV ejection fraction, % | 63.0 (±8.7) | 62.0 (±7.9) | 0.097 |
GLS | −19.8 (±3.5) | −19.9 (±2.6) | 0.79 |
LV mass index, gram/m2 | 68.5 (±18.0) | 73.0 (±22.4) | 0.66 |
Troponin-T, µg/mL | 6 (3–8) | 7 (4–9) | 0.43 |
NT-proBNP, ng/L | 89 (47–142) | 69 (42–155) | 0.10 |
Disease activity parameters | |||
DAS28 | 4.44 (±1.23) | 2.72 ± 1.23 | <0.001 * |
CRP, mg/L | 6.3 (3.1–20.0) | 2.6 (0.8–7.6) | 0.009 * |
ESR, mm/h | 23 (9.0–43) | 8 (5–15) | <0.001 * |
HAQ | 1.3 (0.8–1.5) | 0.5 (0.0–1.3) | 0.001 * |
E/e’ > 9 (n) | Baseline | Follow-Up | p-Value |
---|---|---|---|
E/A (6) | 1.0 (±0.4) | 1.0 (±0.3) | 0.97 |
E/e’ (7) | 11.8 (±3.0) | 10.9 (±4.2) | 0.34 |
deceleration time, sec (4) | 0.23 (±0.06) | 0.26 (±0.05) | 0.34 |
ejection fraction (4) | 62.0 (±7.4) | 62.2 (±9.5) | 0.97 |
LV mass index, gram/m2 (5) | 83.0 (±26.1) | 100.6 (54.1) | 0.28 |
LA volume index, mL/m2 (4) | 36.6 (±3.8) | 36.6 (±3.8) | 0.87 |
GLS (6) | −18.0 (±3.5) | −18.2 (±2.7) | 0.90 |
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Baniaamam, M.; Handoko, M.L.; Agca, R.; Heslinga, S.C.; Konings, T.C.; van Halm, V.P.; Nurmohamed, M.T. The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study. J. Clin. Med. 2020, 9, 3145. https://doi.org/10.3390/jcm9103145
Baniaamam M, Handoko ML, Agca R, Heslinga SC, Konings TC, van Halm VP, Nurmohamed MT. The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study. Journal of Clinical Medicine. 2020; 9(10):3145. https://doi.org/10.3390/jcm9103145
Chicago/Turabian StyleBaniaamam, Milad, M. Louis Handoko, Rabia Agca, Sjoerd C. Heslinga, Thelma C. Konings, Vokko P. van Halm, and Mike T. Nurmohamed. 2020. "The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study" Journal of Clinical Medicine 9, no. 10: 3145. https://doi.org/10.3390/jcm9103145