Silent Coronary Artery Disease in Patients with Rheumatoid Arthritis in Kurdistan, Iraq: A cross-sectional study

Objectives: This study attempts to determine the silent coronary artery disease (CAD) in a sample of Iraqi Kurdish patients diagnosed with rheumatoid arthritis (RA). Methods: A total of 50 such patients from Duhok, Kurdistan region of Iraq, underwent multi slices computed tomography (MSCT) coronary angiography 64 slices to determine coronary artery calcium (CAC) scores and coronary stenoses. Results: 62% of cases had a (CAC) score > zero on non-contrast MSCT scans. Coronary angiograms showed that 26 (52%) of the cases had variable coronary artery stenosis; 17(34%) of them were obstructive (>50% luminal narrowing). The study demonstrated that Inflammatory markers (rheumatoid factor, Anti- cyclic citrullinated peptides, and some cardiovascular risk factors, namely (hypertension and type 2 diabetes mellitus) were significantly related to the presence of CAD in these patients. Conclusions: Patients with rheumatoid arthritis are at increased risk of CAD. This risk is higher in the presence of inflammatory and cardiovascular risk factors.