Background/Purpose: Rheumatoid arthritis (RA) patients have a higher risk of developing left ventricular (LV) geometry abnormalities which can result in cardiac death. High titers of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies are associated with a worse cardiovascular (CV) prognosis in RA patients.

The aim of this study was to assess the association between RF and anti-CCP antibody titers and LV geometry abnormalities detected by a transthoracic echocardiogram.

Methods: This was a cross-sectional, observational, and comparative study. Patients aged 40-75 years who fulfilled the 2010 ACR/EULAR classification criteria underwent a transthoracic echocardiogram. Patients with RA and LV geometry abnormalities were matched to RA-patients without LV geometry abnormalities, by age, gender, comorbidities, and disease characteristics. LV geometry was evaluated with LV mass index and relative wall thickness. A blood sample was taken to measure RF and anti-CCP antibody titers. Comparisons were done with χ² test for qualitative variables and Student’s t test and Mann-Whitney’s U test for quantitative variables. A p-value < 0.05 was considered statistically significant.

Results: A total of 82 RA-patients were included in this study, 41 patients with LV geometry abnormalities and 41 patients without LV geometry abnormalities. Of the 41 patients with LV geometry abnormalities, 37 (90.2%) presented LV concentric remodeling and 4 (9.8%) presented LV concentric hypertrophy. There were no differences in the demographic and clinical characteristics between both groups (Table 1). Patients with altered LV geometry showed higher titers of IgA-RF (102.11 U/mL vs 21.70 U/mL, p=0.011) and anti-CCP antibodies (193.04 U/mL vs 18.29 U/mL, p=0.005). IgG-RF and IgM-RF showed no significant differences between groups (Figure 1).

Conclusion: RA patients with LV geometry abnormalities had higher titers of IgA-RF and anti-CCP antibodies. This suggests an association between antibody titers and CV prognosis in RA patients. Rheumatologists should take these data into account when evaluating CV risk in RA patients, assessing the possibility of performing an echocardiogram for early detection of CV abnormalities and an opportune treatment in this group of patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/abnormalities-in-left-ventricular-geometry-influenced-by-higher-rheumatoid-factor-and-anti-cyclic-citrullinated-peptide-antibody-titers-in-rheumatoid-arthritis-patients/