Effect of high-intensity statin treatment in rheumatoid arthritis: a case with possible coronary atheroma regression and progression of rheumatoid valve degeneration

Summary

Rheumatoid arthritis (RA) is complicated by high mortality from cardiovascular disease. Statins have been shown to reduce cardiovascular disease events by approximately 30% and to induce coronary atheroma regression. There is no such documentation in patients with RA. This report describes a 49-year-old patient with RA who developed coronary atherosclerosis and rheumatoid valve disease. She underwent coronary artery bypass graft operation with two bypasses and a biological aortic valve replacement. Simultaneously, she was started on atorvastatin 80 mg, and low-density lipoprotein cholesterol reached 1.79 mmol/l and high-density lipoprotein cholesterol reached 1.59 mmol/l. One year after the heart surgery, she developed rheumatoid disease of the mitral valve. Coronary angiography revealed no signs of filling defect in her native coronary arteries. This case indicates that high-dose statin treatment may induce coronary atheroma regression in RA patients and that the rheumatoid valve disease process is not modulated by statins.