Serum Anti-malondialdehyde-acetaldehyde IgA Antibody Concentration Improves Prediction of Coronary Atherosclerosis Beyond Traditional Risk Factors in Patients with Rheumatoid Arthritis

Hannah Lomzenski¹, Geoffrey Thiele², Michael Duryee², Sheau-Chiann Chen¹, Fei Ye¹, Ted Mikuls², C. Michael Stein¹ and Michelle Ormseth¹, ¹Vanderbilt University Medical Center, Nashville, TN, ²University of Nebraska Medical Center, Omaha, NE

Meeting: ACR Convergence 2020

Keywords: Biomarkers, Cardiovascular, Inflammation, rheumatoid arthritis, risk factors

Session Information

Date: Sunday, November 8, 2020

Title: RA – Diagnosis, Manifestations, & Outcomes Poster III: Cardiopulmonary Aspects

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Patients with rheumatoid arthritis (RA) have increased cardiovascular disease (CVD) independent of traditional risk factors. Oxidative stress is increased in patients with RA and may contribute to CVD. Malondialdehyde-acetaldehyde (MAA) protein adducts are highly immunogenic products of oxidative stress; and anti-MAA antibodies are detectable in human serum. The aim of this study was to examine the relationship between anti-malondialdehyde-acetaldehyde (MAA) antibody concentrations and CVD risk factors in patients with RA and determine their utility as a predictive biomarker for coronary atherosclerosis.

Methods: In this cross-sectional study, serum concentrations of anti-MAA antibody isotypes (IgA, IgG, and IgM) were measured in 166 patients with RA by ELISA. The relationship between serum anti-MAA antibody concentrations and cardiometabolic measures in RA patients were examined by Spearman correlation. The predictive accuracy of anti-MAA antibodies for presence of any coronary artery calcium (CAC) and high CAC (≥300 Agatston units or ≥75^th percentile) were examined by calculating the c-statistic with bootstrapping for internal validation of each fitted logistic regression model.

Results: Serum IgA anti-MAA antibody concentration was modestly associated with increased CAC (Rho=0.18, P=0.02), insulin resistance (Rho=0.18, P=0.03), and decreased high-density lipoprotein (HDL) particle number (Rho=-0.20, P=0.01). Serum IgG and IgM anti-MAA antibodies were not associated with increased CAC. The addition of anti-MAA IgA antibody concentration as an interaction term with ACC/AHA 10-year risk score improved the c-statistic from 0.83 to 0.85 for prediction of presence of CAC and improved the c-statistic from 0.72 to 0.75 for prediction of high CAC.

Conclusion: Anti-MAA IgA concentration is significantly associated with several non-traditional cardiovascular risk factors in patients with RA. Anti-MAA IgA concentration may aid in prediction of elevated atherosclerotic cardiovascular disease and risk stratification when added to standard measures of cardiovascular risk.

Disclosure: H. Lomzenski, None; G. Thiele, None; M. Duryee, None; S. Chen, None; F. Ye, None; T. Mikuls, Horizon Therapeutics, 2; C. Stein, None; M. Ormseth, None.

To cite this abstract in AMA style:

Lomzenski H, Thiele G, Duryee M, Chen S, Ye F, Mikuls T, Stein C, Ormseth M. Serum Anti-malondialdehyde-acetaldehyde IgA Antibody Concentration Improves Prediction of Coronary Atherosclerosis Beyond Traditional Risk Factors in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/serum-anti-malondialdehyde-acetaldehyde-iga-antibody-concentration-improves-prediction-of-coronary-atherosclerosis-beyond-traditional-risk-factors-in-patients-with-rheumatoid-arthritis/. Accessed .

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