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SAT0138 Left Ventricular Function at 2-Year Follow-Up in Treatment-Naive Rheumatoid Arthritis Patients Is Associated with Anti-Ccp Status: A Cohort Study
  1. B.B. Løgstrup1,
  2. D. Masic2,
  3. T.B. Laurbjerg2,
  4. J. Blegvad2,
  5. M. Herly2,3,
  6. L.D. Kristensen2,
  7. G. Urbonaviciene2,
  8. A. Hedemann-Nielsen4,
  9. T. Ellingsen3,5,6
  1. 1Department of Cardiology, Aarhus University Hospital, Aarhus
  2. 2Diagnostic Center, Regional Hospital Silkeborg, Silkeborg
  3. 3Department of Rheumatology, Odense University Hospital, Odense
  4. 4Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg
  5. 5Clinical Institute, University of Southern Denmark, Odense
  6. 6Danbio Registry, Glostrup, Denmark

Abstract

Background In patients with rheumatoid arthritis (RA) the role of autoimmunity and especially auto antibody status and the time-course of left ventricular (LV) function is unknown.

Objectives To assess LV function as well as the amount of coronary calcium by coronary computer tomography (CCT) in relation to anti-cyclic citrullinated peptide antibody (anti-CCP) status in a cohort of treatment-naive RA patients. Furthermore to assess changes in these parameters during a 2-year follow-up period.

Methods Sixty-six steroid- and DMARD-naive RA patients (42 women) were included and treated with methotrexate according to the national guidelines. We assessed both the LV function by conventional echocardiography and speckle-tracking echocardiography. Furthermore, we performed CCT to estimate the amount and progression of coronary calcium. Patients were examined at he time of diagnosis and after 2-years of efficient anti-inflammatory treatment.

Results All patients fulfilled the international criteria for RA. We found no clinical significant differences in LV function parameters during the 2-year follow-up period in the total population. However, we found that patients with a persistently elevated anti-CCP both had a significantly lack of improvement in S'(1±1.4 cm/s versus 0.2±0.9 cm/s; p=0.04) and had a worsening in global longitudinal systolic strain (GLS) (0.6±1.8% versus -1±2.8%; p=0.04) compared to patients with non-persistently elevated anti-CCP over a 2-year time period. Furthermore, we observed a significant correlation between ΔGLS over 2 years and anti-CCP at 2-year follow-up (r=0.36;p=0.006). It remained significantly correlated (p=0.008) after correction for relevant cofounders (age, gender, blood pressure, heart rate, and baseline GLS). The circumferential strain improved in the group with non-persistently elevated anti-CCP compared to the group with persistently elevated anti-CCP (-4.2±3.8% versus 0.3±1.9%; p=0.009). We observed a mean progression of calcium score during the 2-year follow-up period of 22.4±68.9. We observed no differences in progression in calcium score in patients with persistently elevated anti-CCP (n=12) versus not persistently elevated (n=32) (23.8±40.3 versus 22.6±68.9; p=0.96).

Conclusions LV function and deformation is reduced in treatment-naive RA patients with persistently elevated anti-CCP. Deformation abnormalities is associated with the degree of anti-CCP positivity in a 2-year follow-up period. No differences in the amount of coronary calcium was observed according to inflammatory burden.

Disclosure of Interest None declared

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