RESEARCH - Association between anti-CCP antibodies and ischemic heart disease in patients with RA

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Arthritis Rheum. 2009 Mar 30;61(4):419-424.

Association between anti-cyclic citrullinated peptide antibodies and

ischemic heart disease in patients with rheumatoid arthritis.

López-Longo FJ, Oliver-Miñarro D, de la Torre I, González-Díaz de

Rábago E, Sánchez-Ramón S, Rodríguez-Mahou M, Paravisini A, Monteagudo

I, González CM, García-Castro M, Casas MD, Carreño L.

Hospital General Universitario Gregorio Marañón, Madrid, Spain.

OBJECTIVE: Patients with rheumatoid arthritis (RA) have an increased

risk of cardiovascular disease that may not always be related to the

presence of traditional cardiovascular risk factors. The aim of this

study was to determine if anti-cyclic citrullinated peptide (anti-CCP)

antibodies are associated with cardiovascular disease in patients with

RA.

METHODS: Anti-CCP antibodies were determined by enzyme-linked

immunosorbent assay in the earliest serum sample available from 937

patients with a diagnosis of RA. We studied the relationship between

anti-CCP antibodies with traditional cardiovascular risk factors and

cardiovascular events.

RESULTS: We found positive anti-CCP antibodies (>25 units/ml) in 672

patients (71.7%). There was no association between the anti-CCP

antibodies and cardiovascular risk factors such as smoking,

hypertension, dyslipidemia, being overweight, or diabetes mellitus.

However, patients who had positive anti-CCP antibodies experienced

more frequent ischemic heart disease (6.5% versus 2.6%; odds ratio

[OR] 2.58, 95% confidence interval [95% CI] 1.17-5.65) and had higher

mortality rates (11.2% versus 6.8%; OR 1.72, 95% CI 1.01-2.91).

Similar results were obtained when we considered anti-CCP titers

20-fold higher (>500 units/ml). Multivariable analysis showed that

ischemic heart disease is independently associated with positive

anti-CCP antibodies (OR 2.8, 95% CI 1.19-6.56; P = 0.009).

CONCLUSION: Anti-CCP antibodies in patients with RA are independently

associated with the development of ischemic heart disease.

PMID: 19333979

http://www.ncbi.nlm.nih.gov/pubmed/19333979

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