RESEARCH - Autoantibodies and the risk of cardiovascular events

October 30, 2009

J Rheumatol. 2009 Oct 15.

Autoantibodies and the Risk of Cardiovascular Events.

Liang KP, Kremers HM, Crowson CS, Snyder MR, Therneau TM, VL, SE.

From the Department of Medicine and Division of Rheumatology,

University of Pittsburgh, Pittsburgh, Pennsylvania; Department of

Medicine and Division of Rheumatology; Department of Health Sciences

Research; Department of Laboratory Medicine and Pathology, Mayo

Clinic; and Division of Cardiology, Mayo Clinic and Mayo Graduate

School of Medicine, Rochester , Minnesota, USA.

OBJECTIVE: Inflammation and autoimmunity are associated with increased

cardiovascular (CV) risk in patients with rheumatoid arthritis. This

association may also be present in those without rheumatic diseases.

Our purpose was to determine whether rheumatoid factor (RF),

antinuclear antibody (ANA), and cyclic citrullinated peptide antibody

(CCP) positivity are associated with increased risk of CV events and

overall mortality in those with and without rheumatic diseases.

METHODS: We performed a population-based cohort study of all subjects

who had a RF and/or ANA test performed between January 1, 1990, and

January 1, 2000, and/or CCP test performed between September 1, 2003,

and January 1, 2005, with followup until April 1, 2007. Outcomes were

ascertained using diagnostic indices from complete medical records,

including CV events [myocardial infarction (MI), heart failure (HF),

and peripheral vascular disease (PVD)] and mortality. models were

used to analyze the data.

RESULTS: There were 6783 subjects with RF, 7852 with ANA, and 299 with

CCP testing. Of these, 10.4%, 23.9%, and 14.7% were positive for RF,

ANA, and CCP, respectively. Adjusting for age, sex, calendar year,

comorbidity, and rheumatic disease, RF and ANA positivity were

significant predictors of CV events [hazard ratio (HR) 1.24 and 1.26]

and death (HR 1.43 and 1.18). Adjusting for age, CCP positivity was

associated with CV events, but this association was not statistically

significant (HR 3.1; 95% CI 0.8, 12.3).

CONCLUSION: RF and ANA positivity are significant predictors of CV

events and mortality in both those with and those without rheumatic

diseases. These results support the role of immune dysregulation in

the etiology of CV disease.

PMID: 19833748

Not an MD

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