Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
A recent study has suggested that the excess cardiovascular (CV) risk observed in patients with rheumatoid arthritis (RA) could be partially explained by immune-complexes of antibodies against citrullinated proteins that locally promote and perpetuate inflammation and progression of atherosclerotic plaques (1). Our aim has been to replicate one of the observations supporting this hypothesis: association between anti-citrullinated fibrinogen (citFib) and subclinical atherosclerosis.
Three surrogate markers of atherosclerosis were assessed in 124 patients with RA, with no previous history of CV events: carotid intima-media thickness (cIMT) and carotid plaques assessed by carotid ultrasonography (US), and coronary artery calcification score (CACS) performed by multi-detector computed tomography (MDCT) scan. We analyzed the relationship of these three markers of subclinical atherosclerosis with the presence and levels of autoantibodies, including anti-citFib, anti-CCP2 and RF.
CV risk based on gender, age, cholesterol, systolic blood pressure and smoking status was low or moderate for most patients, and only 17 patients showed ≥ 5 % risk of fatal events in 10 years according with classical risk factors. In contrast, most patients (81.4 %) showed at least one sign of subclinical aterosclerosis: carotid plaques were present in 69.4 % of the patients, moderate to high CACS in 21.0 %, and cIMT > 0.9 mm in 15.6 %. None of these surrogate markers of atherosclerosis showed a significant association with anti-citFib antibodies (either against the whole protein present in 33.9 % of the patients, or against an immunodominant peptide present in 23.4 %) or with anti-CCP2 (60.7 %) or RF (58.1 %) in this series of patients with RA. In addition, no significant association was observed when the patients were analyzed according to sex, seropositive status RA or combined atherosclerosis surrogate markers.
Our results do not support a relationship between anti-citFib antibodies and subclinical atherosclerosis in RA questioning the claim that these antibodies have a role in the increased risk of CV disease observed in patients with RA.
Sokolove J, et al. Arthritis Rheum. 2013;65:1719-24.
Funded by Instituto de Salud Carlos III (Spain), grants PI11/01048 and RD12/0009/0008 that are partially financed by the European Regional Development Fund of the European Union
To cite this abstract in AMA style:Montes A, Corrales A, Calaza M, López-Mejías R, Parra JA, Gonzalez-Gay MA, Gonzalez A. Lack of Replication of the Association Between Anti-Citrullinated Fibrinogen and Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/lack-of-replication-of-the-association-between-anti-citrullinated-fibrinogen-and-subclinical-atherosclerosis-in-patients-with-rheumatoid-arthritis/. Accessed April 13, 2021.
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