The primary outcome was change in CFR at baseline and 24 weeks with a secondary outcome of change in hs-cTnT. Blood measurements for routine lipids, inflammatory markers including hsCRP, IL-6, IL-1beta, and hs-cTnT were also performed at baseline and follow-up. A lower CFR in the absence of obstructive coronary artery disease (CAD) is indicative of CMD, defined as CFR< 2.5. Coronary flow reserve (CFR) is calculated from cardiac PET data using a ratio of myocardial blood flow (MBF) during maximal hyperemia over that at rest. All subjects underwent a stress myocardial perfusion PET scan (cardiac PET) at baseline and after 24 weeks. Exclusion criteria include prior CVD, statin use, prednisone dose >10mg, or prior biologic DMARD use. Methods: The Lipids, Inflammation and CV risk in RA (LiiRA) study was a case-crossover study, recruiting RA patients age ≥18 years with active disease about to initiate a TNFi as part of clinical care. The objective of this study was to determine the association between a reduction in inflammation with changes in CV risk as measured by CFR and hs-cTnT, as part of the LiiRA study. Additionally, subclinical myocardial injury can be assessed with high sensitivity cardiac troponin (hs-cTnT).
Coronary flow reserve (CFR) is a quantitative imaging biomarker of CV risk that can detect coronary microvascular disease (CMD), associated with higher mortality in RA.
Brittany weber 1, Dana Weisenfeld 1, Thany Seyok 1, Elena Massarotti 1, Selena Huang 1, Derrick Todd 1, Jonathan Coblyn 1, michael weinblatt 1, Tianrun Cai 1, Kumar Dahal 1, leanne BArrett 1, Daniel Solomon 1, Jorge Plutzky 1, Marcy Bolster 2, marcelo Dicarli 1 and Katherine Liao 1, 1Brigham and Women's Hospital, Boston, MA, 2Massachusetts General Hospital, Boston, MAīackground/Purpose: Patients with rheumatoid arthritis (RA) are at increased cardiovascular (CV) risk.
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