SAT0142 Pulmonary hypertension among hispanic patients with rheumatoid arthritis: a case-control study

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, multifactorial disease that mainly affects synovial joints. Pulmonary artery hypertension (PAH) can appear as a complication of connective tissue diseases. It is possible that pulmonary artery systolic pressure (PASP) in RA may be elevated due to interstitial lung disease, pulmonary vasculitis, pulmonary veno-occlusive disease, or cardiac disease (1). Although right heart catheterization is the gold standard, Doppler echocardiography has proved to be a reliable non-invasive method for detecting PAH (2). Objectives: To determine the prevalence of PAH in RA patients and compare it to matched controls. Methods: A case-control study with RA patients aged 40 to 75 years that fulfilled the 2010 ACR/EULAR criteria and matching controls were included. Exclusion criteria: poor acoustic window, absence of tricuspid regurgitation (TR), prior atherosclerotic cardiovascular (CV) disease and overlap syndromes. Patients were matched using age, sex and comorbidities. Transthoracic echocardiogram was performed by a board-certified cardiologist. PASP was calculated using the Bernoulli equation: TR velocity2 × 4 + right atrial pressure according to ASE's guidelines. We used Denton's definition of PAH on Doppler echocardiography as an estimated PASP ≥30 mmHg (3). Results: A total of 76 RA patients and 52 matched controls were included. Demographic and clinical characteristics of both groups are shown on table 1. As shown on table 2, the mean PASP was higher RA patients (27.14±6.34 mmHg) than controls (24.68±5.44 mmHg) (P=0.024). PASP ≥30 mmHg prevalence was significantly higher in RA patients (34.2% vs 11.5%; P=0.004). (Table Presented) suggesting PAH, was more prevalent on RA patients than controls. A higher number of CV events that cannot be explained by traditional risk factors have been reported in RA patients; and it is possible that the elevation in the PASP could contribute to the problem. Prospective studies are needed to evaluate the role of elevated PASP in morbidity and mortality of RA patients.