ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0572

Circulating Cytokines and Chemokines Are Associated with the Risk of Incident Cardiovascular Disease in Rheumatoid Arthritis Independent of Conventional Disease Activity Measures

Tate Johnson1, Michael Duryee2, Carlos Hunter2, Punyasha Roul2, Yangyuna Yang2, Joshua Baker3, Geoffrey Thiele2, Ted Mikuls2 and Bryant England2, 1University of Nebraska Medical Center, Elkhorn, NE, 2University of Nebraska Medical Center, Omaha, NE, 3University of Pennsylvania, Philadelphia, PA

Meeting: ACR Convergence 2021

Keywords: Cardiovascular, cytokines, rheumatoid arthritis

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 7, 2021

Title: Epidemiology & Public Health Poster II: Inflammatory Arthritis – RA, SpA, & Gout (0560–0593)

Session Type: Poster Session B

Session Time: 8:30AM-10:30AM

Background/Purpose: Cardiovascular disease (CVD) is the leading cause of death in rheumatoid arthritis (RA). While chronic inflammation contributes to CVD pathogenesis, the role of specific circulating inflammatory mediators with CVD risk in RA is unclear. Because existing risk calculators underestimate CVD risk in RA patients, additional biomarkers to prognosticate CVD risk are needed. We evaluated the associations of serum cytokines and chemokines with incident major adverse cardiovascular events (MACE) and whether subclinical inflammation as assessed by these mediators predicts future CVD.

Methods: We included patients from a prospective, multicenter cohort of US Veterans with RA between 2003-2020 and followed them from enrollment to incident MACE, death, or end of follow-up. MACE was defined as a composite of myocardial infarction, coronary revascularization, stroke, or CVD-related death and identified with previously validated algorithms using ICD codes and the National Death Index. A multiplex assay was used to measure cytokines and chemokines (n=33) using serum banked at study enrollment. Values were log-transformed, standardized, and considered elevated if >2 SD above the mean. Covariates included demographics, smoking status, BMI, comorbidities (hypertension, diabetes, lung disease, prior MACE), LDL cholesterol, DAS28, and medications (methotrexate, TNFi, prednisone) at enrollment. Associations between individual analytes with incident MACE were estimated using multivariable Cox regression. In secondary analyses, we additionally adjusted for DAS28 and restricted the cohort to patients in remission or low disease activity (LDA).

Results: We studied 2,712 RA patients (mean age 72 years, 90% male, mean DAS28 of 3.7). We identified 406 MACE outcomes over 22,216 person-years of follow-up (19.3 events per 1,000 PY, mean time to event 4.9 years). After multivariable adjustment including traditional CVD risk factors, 12 of 33 analytes were significantly associated with an increased risk of MACE (HR per 1 SD range 1.11-1.22). Associations between cytokines / chemokines and incident MACE persisted after further adjusting for baseline DAS28 (Figure 1). Among 683 patients in remission/LDA at enrollment, 97 MACE outcomes occurred in follow-up. Five analytes (IL-6, IL-15, IL-17A, IFN-g, and macrophage inflammatory protein-3-ɑ) remained associated with incident MACE (HR range 1.19-1.50) in these patients. The number of elevated cytokines was associated with an increased risk of MACE in the overall (HR 1.06 [95% CI 1.01-1.10]) and LDA / remission cohort (HR 1.11 [1.06-1.11]).

Conclusion: In a prospective, multicenter RA cohort, several circulating cytokines and chemokines were associated with a heighted risk of incident MACE, independent of traditional CVD risk factors and clinical RA disease activity. Elevated concentrations of these pro-inflammatory mediators similarly predicted MACE even in those in LDA or remission. Together, these findings suggest that measuring pro-inflammatory mediators in RA patients may aid in CVD risk stratification and prevention beyond existing traditional and RA-related CVD risk factors.

Figure 1. Association of circulating cytokine and chemokine concentrations with incident major adverse cardiovascular events in rheumatoid arthritis


Disclosures: T. Johnson, None; M. Duryee, None; C. Hunter, None; P. Roul, None; Y. Yang, None; J. Baker, Bristol-Myers Squib, 2, Pfizer, 2; G. Thiele, Regeneron, 6; T. Mikuls, Gilead Sciences, 2, Horizon, 2, 5, Pfizer Inc, 2, Sanofi, 2, Bristol-Myers Squibb, 2; B. England, Boehringer-Ingelheim, 2.

To cite this abstract in AMA style:

Johnson T, Duryee M, Hunter C, Roul P, Yang Y, Baker J, Thiele G, Mikuls T, England B. Circulating Cytokines and Chemokines Are Associated with the Risk of Incident Cardiovascular Disease in Rheumatoid Arthritis Independent of Conventional Disease Activity Measures [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/circulating-cytokines-and-chemokines-are-associated-with-the-risk-of-incident-cardiovascular-disease-in-rheumatoid-arthritis-independent-of-conventional-disease-activity-measures/. Accessed .
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/circulating-cytokines-and-chemokines-are-associated-with-the-risk-of-incident-cardiovascular-disease-in-rheumatoid-arthritis-independent-of-conventional-disease-activity-measures/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology