• Jérôme Avouac, Christophe Meune, Camille Chenevier-Gobeaux, Philippe Dieudé, Didier Borderie, Guillaume Lefevre, André Kahan, and Yannick Allanore.
• From the Paris Descartes University, Sorbonne Paris Cité, Rheumatology A department, Cochin Hospital; Paris Descartes University, INSERM U1016 and CNRS UMR8104, Cochin Institute, Paris; Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Cardiology Department, Bobigny; Clinical Chemistry Laboratory, Cochin and Hôtel-Dieu Hospitals; Paris 7 University, Rheumatology department, Bichat Claude Bernard Hospital; Clinical Chemistry and Hormonology Department, Tenon Hospital, Paris, France.
• J Rheumatol. 2014 Feb 1; 41 (2): 248-55.

ObjectiveTo measure concentrations of high-sensitivity cardiac troponin (HS-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with rheumatoid arthritis (RA) and to examine correlates.MethodsThe plasma concentrations of HS-cTnT and NT-proBNP were measured in consecutive patients with RA and compared to values obtained from age-matched and sex-matched healthy controls.ResultsWe included 236 unrelated patients with RA (192 females, 57 ± 13 yrs) and 213 controls (170 females, 55 ± 15 yrs). Seventy-one patients with RA were free of cardiovascular (CV) risk factors. HS-cTnT and NT-proBNP concentrations were significantly higher in the total cohort of patients with RA (p = 0.03 and p < 0.0001, respectively) and in the subgroup free of CV risk factors (p = 0.02 and p < 0.0001, respectively) compared to controls. In addition, both the total cohort of patients with RA and the subgroup free of CV risk factors were more likely to have levels above the cutoff concentrations of HS-cTnT (p = 0.003 and p = 0.007, respectively) and NT-proBNP (p = 0.0001 and p < 0.0001, respectively) than controls. Patients with RA and increased C-reactive protein (CRP) levels had higher HS-cTnT (p = 0.03) and NT-proBNP (p = 0.02) concentrations. HS-cTnT levels positively correlated with the 28-joint Disease Activity Score (DAS28-CRP; r = 0.2, p = 0.020). Multivariate logistic regression analysis indicated that increased HS-cTnT levels were independently associated with a DAS28-CRP > 5.1 (OR 11.8; 95% CI 1.6-35.5) and a body mass index > 30 kg/m(2) (OR 2.7; 95% CI 1.3-5.5).ConclusionHS-cTnT and NTproBNP are increased in patients with RA, independent of CV risk factors. The association between HS-cTnT, NT-proBNP, and CRP, together with the correlation between HS-cTnT and disease activity, support the link between myocardial injury/dysfunction and inflammation.

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