Study links hs-cTnT to MACE, mortality in rheumatoid arthritis

For patients with rheumatoid arthritis (RA), a detectable level of high-sensitivity cardiac troponin T (hs-cTnT) is associated with increased risk of major adverse cardiovascular events (MACE) and all-cause mortality, according to a research letter published online June 15 in the Journal of Rheumatology.

Brittany N. Weber, M.D., Ph.D., from Brigham and Women’s Hospital in Boston, and colleagues examined the longer-term association between clinically established thresholds for detectable hs-cTnT with MACE (acute coronary syndrome, stroke, and cardiovascular death) and all-cause mortality among 331 patients with RA.

The median calculated 10-year atherosclerotic cardiovascular disease (ASCVD) risk was 3.87%. The researchers found that 117 patients (35.3%) had detectable hs-cTnT (median level, 8.98 mg/dL). In 10 years, 16 MACE occurred (4.8%), with 50 all-cause deaths (15.1%).

There was an association seen for detectable hs-cTnT with future MACE (hazard ratio [HR], 7.13); the significant association persisted after adjustment for ASCVD risk and log high-sensitivity C-reactive protein (hsCRP; HR, 4.29) and for baseline ASCVD risk and Disease Activity Score in 28 joints based on CRP (DAS28-CRP). Corresponding associations were seen for detectable hs-cTnT and all-cause mortality (HR, 7.2), which also persisted after adjustment (HRs, 4.18 and 4.74, respectively). ASCVD risk score alone was significantly associated with MACE.

“These findings suggest that hs-cTnT may be a useful marker to improve cardiovascular risk assessment among patients with RA with overall low estimated ASCVD risk,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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