Ubedul Islam1, Chitralekha Baruah2, Pradeep Kumar Das3, Smarakranjan Rout4
BACKGROUND
Rheumatoid Arthritis (RA) is a chronic inflammatory disease of unknown aetiology marked by a symmetric and peripheral polyarthritis, which often results in joint damage and physical disability. Rheumatoid arthritis is not just only a disease affecting joints, but it goes well beyond the barricade of arthritis into systemic inflammatory manifestations. Various factors play an important role in the morbidity and mortality of the disease.
The aim of this study was to investigate the clinical spectrum of rheumatoid arthritis with special reference to dyslipidaemia and cardiovascular manifestations.
MATERIALS AND METHODS
We conducted a hospital-based observational study comprising of 72 patients of rheumatoid arthritis who had been diagnosed, based on criteria laid down by 2010 ACR/EULAR classification criteria, admitted in Gauhati Medical College and Hospital, Guwahati, Assam (India) and fulfilled the inclusion and exclusion criteria. Statistical analysis was performed using GraphPad InStat version 3.00 for Windows 7, GraphPad Software, San Diego, California, USA (www.graphpad.com). P value <0.05 was taken as statistically significant.
RESULTS
In this study, out of 72 patients, 16 patients were male and 56 patients were female, 31.94% cases were in the 5th decade of life followed by the 4th decade (30.56%) with a mean age of 43.63 years. Our study found that the most common derangement of lipid parameter was being attributed to low HDL level (31%) followed by a high triglyceride level (20.83%). The prevalence of dyslipidaemia was 41.67%. Atherogenic index was high in 23.6% of the cases with a mean of 4.52 of borderline range. In this study, ECG abnormalities were present in 12.5% of study subjects, abnormal echocardiography findings were present in 11.11% of patients and abnormal carotid Doppler findings were present in 18%. The most common ECG abnormality was nonspecific ST-T changes, most common echocardiographic abnormality was pericardial effusion, most common abnormal carotid Doppler finding was increased IMT. As a whole, 27.78% patients of the study population was having cardiovascular manifestations. Statistical analysis shows a significant association between dyslipidaemia and disease activity (P<0.05) and with cardiovascular manifestations (P<0.0001).
CONCLUSION
From this study, it was concluded that, Dyslipidaemia is common in RA patients with low HDL-Cholesterol being the commonest abnormality in this part of the country. Overt cardiovascular manifestations in the form of advanced atherosclerosis, Ischaemic Heart Disease, Pericarditis are also commonly encountered in patients with RA.
