# Multivessel Coronary Artery Disease in a Patient Treated With Tofacitinib: A Case Report

## TL;DR

A 73-year-old man with rheumatoid arthritis and hypertension developed significant coronary artery disease while being treated with tofacitinib, a JAK inhibitor.

## Contribution

This case report highlights a potential link between tofacitinib use and multivessel coronary artery disease.

## Key findings

- The patient presented with cardiac chest pain, ischemic EKG changes, and elevated troponin levels.
- Cardiac catheterization revealed significant multivessel coronary artery disease.
- The case suggests a possible association between tofacitinib and cardiovascular risk.

## Abstract

Tofacitinib is a second-generation selective Janus kinase (JAK) inhibitor targeting the JAK1 enzyme, which is used to treat several autoimmune diseases, including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, idiopathic arthritis, and ulcerative colitis. JAKs are enzymes that play a key role in inflammatory and immune signaling pathways. The medication is particularly useful as it can be given orally. However, over time, there has been much data that links this drug with an increased risk of cardiovascular events. We present a case of a 73-year-old male with a history of RA and hypertension presenting to the hospital with typical cardiac chest pain. He was found to have ischemic EKG changes and elevated troponin levels. He then underwent cardiac catheterization, which revealed significant coronary artery disease.