Background Accelerated atherosclerosis (AE) and increased arterial stiffness are comorbidities of rheumatoid arthritis (RA) and are related to the inflammatory burden of the disease, as well as to certain clinical and genetic characteristics of the disease. There is controversy about the role of ACPA in the development of AE in these patients.
Objectives To explore the relation between ACPA and RF titres and subclinical vascular damage in RA patients.
Methods Descriptive cross-sectional study with analytical components. A total of 244 RA patients were recruited consecutively over a period of 18 months (2013–2014) in a rheumatology department of a tertiary hospital. Patients with high vascular risk (vascular ischemic events, renal failure and diabetes mellitus) were excluded. Demographics, clinical data (ACPA and RF titres, duration of disease, hypertension and dyslipidemia) and vascular damage (atheroma plaque, carotid intima thickness [IMTc] and pulse wave velocity [PWV]) were collected. The atheroma plaque and IMTc measurement was performed by ultrasonography of the carotid arterial tree using an Esaote® MyLab70XVG with a 7–12 MHz linear transducer and an automated program measuring intima-media thickness (IMT) through radiofrequency (Quality intima media Thickness in real time, QIMT). PWV was obtained by analysis of brachial pulse waves with an automated and validated system (Mobil O Graph®). Statistical analysis was performed with the SPSS 17.0 program.
Results We included 181 patients, 141 (77.9%) women and 40 (22.1%) men, with a mean age of 60.4 years (SD 13.2) and a mean duration of the disease of 13.1 years (SD 10.5); 107 patients (59.1%) were smokers or ex-smokers, 56 (30.9%) hypertensive and 77 (42.5%) dyslipemic. 118 patients (65.2%) had positive ACPA, with a mean value of 330 (SD 621.5), and 107 (59.1%) had a positive value of RF with a mean of 114 (SD 164.5).
No association was found between the positivity of ACPA and RF and the presence of atheroma plaques or with the values of IMTc and/or PWV. In patients with positive ACPA, a positive correlation was observed between ACPA titers and PWV values (p<0.05). In particular, ACPA titers over 1600 were the ones that discriminated the highest values of PWV in our population (p<0.009). The ACPA and RF values, on the other hand, were not related to the presence of plaques or to IMTc.
Conclusions No relation was found between the positivity of RF and ACPA titers and the presence of pathological carotid ultrasound in our RA patient population. However, higher arterial stiffness was observed in patients with high ACPA titers.
Disclosure of Interest None declared