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To the Editor.—
The paper of Irving Karten, MD (210:1717, 1969), reports on 102 consecutive admissions of patients with rheumatoid arthritis in six of whom diffuse vasculitis was present. Two of his patients developed myocardial infarctions, and one came to autopsy with confirmation of coronary arteritis as the cause of the myocardial infarction. This was also suspected in the second patient who survived.Dr. Karten then reviewed 95 autopsy patients with rheumatoid arthritis at the Goldwater Memorial Hospital and found seven who had myocardial infarctions. None of these showed any evidence of coronary arteritis in the available histological sections.In my report on myocardial infarction due to rheumatoid arteritis (199:855, 1967), my review of the literature at that time suggested that of those patients with rheumatoid arthritis and myocardial infarctions who had come to autopsy, the majority had rheumatoid arteritis as the basis for the infarction. In my
Swezey RL. Myocardial Infarction and Rheumatoid Arthritis. JAMA. 1970;212(6):1068. doi:10.1001/jama.1970.03170190082020