Palanivelrajan, S (2010) A Study of correlation between rheumatoid factor and ischemic heart disease in rheumatoid arthritis individuals. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
In the study population, most of the RF positive patients clustered between 30-50 years. Dividing the study population with ischemic changes by ECG, by age, 25% were below 40 years and 75% were above 40 years. All of the above patients had RF positivity along with traditional risk factors and ischemic changes in the ECG. In this study 30% were males and 70% were females. The M : F ratio was 1 : 2.33. 20 patients had ischemic changes in ECG constituting 15 males (50%) and 5 females (7.14%) patients of the total study population. This is concordant with Edwards C J et al1 where the M:F ratio was 1 : 1.02. Comparatively females were more common in present study population. This is because the patients selected were suffering from RA which is more common in females. Considering the ischemic changes, males were affected more than females though more number of female patients were included in the study. This is also similar to Edwards C J et al. Evaluating the 20% (n=20) who were RF positive with ischemic changes, 14 patients had traditional risk factors(70%).The other 6 patients had only RF positivity without any other traditional risk factor. Among these 5 patients were males and there was only one female. This indicates an association of RF and IHD a strong possibility especially in males. Among the 10male patients who had RF positivity with traditional risk factors and ischemic changes, 6 patients had high titre of RF and 4 patients had low titre. Percentage wise 42.85% and 28.57% were having high and low titres of RF along with traditional risk factors causing IHD. This is concordant with both Edwards C J et al, Kenneth J Warrington et al. Among the 4 female patients who had RF positivity with traditional risk factors, 2 patients had ischemic changes with high titre of RF making up 12.5%. 2 patients had ischemic changes with low titre RF and traditional risk factors forming 12.5% This is disconcordant with both Edwards C J et al., Kenneth J Warrington et al. By these data this study shows that, RF with traditional risk factors have increased incidence of ischemic changes in males than females especially with high titre RF. In this study only 6 patients had RF positivity without traditional risk factors along with ischemic changes and among them 5 were males and there was only one female. This is 27.7% of the total RF positive males without traditional risk factors in study population and 16.66% total male patients in the study population. Only one female patient had ischemic changes in ECG with lone RF without traditional risk factor. This is 1.9% of the total RF positive females without traditional risk factors and 1.4% of the total female patients in the study. This study is in concordance with Edwards C J et al. The long term Herfordshire Cohort study reported by Sydall H E et al had similar results. RF positive male patients without traditional risk factors are vulnerable to IHD. Females with traditional risk factors did not have IHD – this is discordant with this study. Our study indicated that IHD may be associated with RF and traditional risk factors in females which is as in the study of Sydall H E et al. Of these 5 male patients, 4 patients had high titre of RF positivity which is 80% and one patient had low titre of RF which is 20%. This suggested that a high titre of RF may have an increased incidence of IHD. This concurs with the earlier study by Edwards C J et al1 and del Puente A et al. In this study, Autoantibody RF which is risk factor for IHD in men is 16.66% (5 out of 30); confidence interval(CI) is 5-28 and 5% (5 out of 100) study population; This goes with many other similar studies from various parts of the world. Most of the of the studies state the prevalence to be between 4-28%. Edwards C J et al. 11.6% (in men), Kenneth J Warrington1 et al. - 1.97% (in general population). From the observation and analysis of study, it is assumed that there is an association between high titre of RF and IHD. This association was significantly more in male patients. This study has a number of potential limitations. The study is conducted with the maximum available resources in the hospital. The most important is the fact that this is a cross-sectional study and will need confirmation by a longitudinal cohort study. CONCLUSIONS : RF can be considered as one of the risk factor for Ischemic heart disease in males. High titre RF alone can further increase the incidence of IHD. RF in association with other traditional risk factors increase the prevalence of IHD. Though more female patients have positive RF ,they are not vulnerable to IHD.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | rheumatoid factor ; ischemic heart disease ; rheumatoid arthritis individuals. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Feb 2018 19:31 |
| Last Modified: | 17 Feb 2018 19:31 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5842 |
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