Presence of rheumatoid factor tied to 10-year cardiovascular disease in RA patients
The presence of rheumatoid factor (RF) rather than anticyclic citrullinated peptide antibodies (anti-CCP) may predict 10-year cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA), a recent study has found.
Researchers sought to determine whether anti-CCP and RF were risk factors for 10-year CVD in RA patients by analysing data from the Nijmegen early RA inception cohort, in which those with newly diagnosed RA (n=929), consecutively included since 1985, were followed up regularly. Anti-CCP and RF were determined at baseline during diagnosis.
The first CVD event (ischaemic heart disease, nonhaemorrhagic cerebrovascular accident [CVA] or peripheral artery disease [PAD]) after baseline as retrieved from physician diagnosis was the primary outcome. Researchers checked fatality against death certificates. They performed Cox regression plus correction for baseline confounders to estimate the effect of anti-CCP, RF and their interaction on 10-year CVD-free survival.
Of the included patients, 628 were anti-CCP‒positive and 697 were RF-positive. There were a total of 162 CV events (101 ischaemic heart disease, 45 CVA and 16 PAD), of which 15 were fatal, during a median follow-up of 7.5 years.
The adjusted hazard ratio (aHR) was 1.17 (95 percent CI, 0.82 to 1.67) for anti-CCP and 1.52 (1.00 to 2.30) for RF. There was an even greater association between RF positivity and CVD among anti-CCP‒negative patients (aHR, 2.09; 1.18 to 3.71). No significant interaction was seen between anti-CCP and RF (p=0.098).
In an earlier study involving postmenopausal women, CVD risk strongly correlated with CVD risk factors, joint pain severity and inflammation, but not with anti-CCP positivity or RF positivity. [Arthritis Rheumatol 2015;67:2311-22]