Background The role of inflammation and anti-cyclic citrullinated peptide antibodies (anti-CCP) in the pathogenesis of cardiovascular disease in early rheumatoid arthritis remains unclear.
Objectives We investigated how disease activity, anti-CCP status and coronary calcium score in treatment-naive early rheumatoid arthritis impacts left ventricular (LV) systolic function.
Methods Fifty-tree patients with steroid- and disease-modifying antirheumatic drug-naive early rheumatoid arthritis were included. Disease activity was scored by the use of the Danish national DANBIO registry (number of swollen joints (NSJ (28)), number of tender joints (NTJ (28)), C-reactive protein (CRP) and Health Assessment Questionnaire (HAQ)). Pain, fatigue, patient and physician global assessment and a composite disease activity score (DAS28-CRP) were assessed by visual analog scales (VAS) 0-100.
Results We found LV systolic function by ejection fraction to be 54.1±9.2% and to be non-significant correlated to disease activity (CRP:r=0.07,p=0.64; baseline NSJ:r=-0.13,p=0.33; NTJ:r=-0.08,p=0.58; HAQ:r=0.23,p=0.1; pain VAS:r=-0.05,p=0.74; fatigue VAS:r=0.03,p=0,83; physician global assessment:r=-0.09,p=0.54 and DAS28:r=-0.03,p=0.84). However, by global longitudinal systolic strain (GLS), we found a significant correlation: HAQ:(r=0.29;p=0.037), patient global assessment by VAS:(r=0.35;p=0.011), patient fatigue assessment by VAS:(r=0.3;p=0.03) and DAS28-CRP:(r=0.28;p=0.043); all corrected for relevant confounders. Furthermore, anti-CCP was highly significantly correlated with GLS (r= -0.44;p=0.001) in univariate analysis. In multivariate analysis, it remained significantly correlated (p=0.018).
We found a significant difference in GLS in patients with high values of anti-CCP (titers ≥340) compared to patients with anti-CCP titers <340); (-19.9±2.1% vs. -16.4±2.8%;p=0.0001). For patients with high IgM-RF titers results were non-significant.
Conclusions We observed a significant correlation between increased disease activity and cardiac function in
treatment-naive early rheumatoid arthritis.
Disclosure of Interest None declared