Background The main causes of death in Rheumatoid Arthritis (RA) are cardiovascular events related to early atherosclerosis, myocardial infarction and congestive heart failure. The risk for cardiovascular disease it it not completely explained by the traditionally accepted cardiovascular risk factors. Inflammatory pathways of RA might be involved in the pathogenesis of subclinical atherosclerosis.
Objectives To evaluate the relationship of anti-CCP antibody titers, serum IL-6, TNFa and high sensitivity c-Reactive Protein with increased carotid intima-media thickness (cIMT) in patients with RA without cardiovascular risk factors.
Methods Sixty patients with RA, 27 anti-CCP positive and 33 anti-CCP negative, and 62 controls (HC) matched by age and gender. All groups were assessed for comorbidities, demographics, clinical evaluations, and cardiovascular risk calculated by atherogenic index of plasma (AIP). The cIMT was performed by high-resolution B-mode ultrasound by a single operator. Serum titers of anti-CCP, hs-cRP, levels of TNFα and IL-6 were measured by ELISA.
Results The anti-CCP positive RA patients showed increased cIMT compared to HC and anti-CCP negative patients (p<0.001). Anti-CCP positive vs. Anti-CCP negative patients, had increased disease activity (DAS28) (p=0.05), increased AIP (p<0.001), higher TNFα (20.54±5.38 vs 32.77±12.30, p=0.002) and IL-6 (18.54±14.09 vs 65.07±34.95, p<0.001). The cIMT correlated with titers of anti-CCP (r=0.539, p<0.001), TNFα (r=0.791, p<0.001) and IL-6 (p=0.794, p<0.001). In multiple regression analysis, cIMT was associated with hs-cRP (p=0.05) and anti-CCP levels (p=0.006).
Conclusions High levels of anti-CCP and hs-cRP are useful markers of an increased cIMT and cardiovascular risk supporting a clinical role of the preventive measurement of cIMT in RA
Disclosure of Interest None declared