Association between anti–cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis
Francisco Javier López-Longo,Desamparados Oliver-Miñarro,Inmaculada de la Torre,Eugenia González‐Díaz de Rábago,Silvia Sánchez-Ramón,Margarita Rodríguez-Mahou,A. Paravisini,Indalecio Monteagudo,Carlos‐Manuel González,Marta García-Castro,María Dolores Casas,Luis Carreño +11 more
TLDR
Patients with rheumatoid arthritis have an increased risk of cardiovascular disease that may not always be related to the presence of traditional cardiovascular risk factors, but patients who had positive anti-CCP antibodies experienced more frequent ischemic heart disease.Abstract:
Objective
Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease that may not always be related to the presence of traditional cardiovascular risk factors. The aim of this study was to determine if anti–cyclic citrullinated peptide (anti-CCP) antibodies are associated with cardiovascular disease in patients with RA.
Methods
Anti-CCP antibodies were determined by enzyme-linked immunosorbent assay in the earliest serum sample available from 937 patients with a diagnosis of RA. We studied the relationship between anti-CCP antibodies with traditional cardiovascular risk factors and cardiovascular events.
Results
We found positive anti-CCP antibodies (>25 units/ml) in 672 patients (71.7%). There was no association between the anti-CCP antibodies and cardiovascular risk factors such as smoking, hypertension, dyslipidemia, being overweight, or diabetes mellitus. However, patients who had positive anti-CCP antibodies experienced more frequent ischemic heart disease (6.5% versus 2.6%; odds ratio [OR] 2.58, 95% confidence interval [95% CI] 1.17–5.65) and had higher mortality rates (11.2% versus 6.8%; OR 1.72, 95% CI 1.01–2.91). Similar results were obtained when we considered anti-CCP titers 20-fold higher (>500 units/ml). Multivariable analysis showed that ischemic heart disease is independently associated with positive anti-CCP antibodies (OR 2.8, 95% CI 1.19–6.56; P = 0.009).
Conclusion
Anti-CCP antibodies in patients with RA are independently associated with the development of ischemic heart disease.read more
Citations
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Journal ArticleDOI
Immunopathogenesis of Rheumatoid Arthritis
TL;DR: Recent data that support intriguing models of disease pathogenesis allude to the possibility of restoration of immunologic homeostasis and thus a state of tolerance associated with drug-free remission of RA, and represents a bold vision for the future of RA therapeutics.
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Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE.
TL;DR: Until additional research and disease-specific risk prediction tools are available, current evidence supports aggressive treatment of disease activity, and careful screening for and management of TRFs.
Journal ArticleDOI
Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives.
TL;DR: More research is necessary to uncover the exact mechanisms responsible for this phenomenon, develop accurate systems used to identify patients at high risk, design and assess prevention strategies specific to this population of patients.
Journal ArticleDOI
Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications.
Bryant R. England,Bryant R. England,Geoffrey M. Thiele,Geoffrey M. Thiele,Daniel R Anderson,Ted R. Mikuls +5 more
TL;DR: Understanding the unique mechanisms for cardiovascular disease in rheumatoid arthritis will aid in risk stratification and the identification of novel targets for meaningful reduction of cardiovascular risk in this patient population.
References
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