Association Between Anti-Cyclic Citrullinated Peptide Antibodies and Ischemic Heart Disease in Patients With Rheumatoid Arthritis
Association Between Anti-Cyclic Citrullinated Peptide Antibodies and Ischemic Heart Disease in Patients With Rheumatoid Arthritis
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DOI：
10.1002/art.24390
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发表时间：
2009-04-15
期刊：
影响因子：
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通讯作者：
Carreno, Luis
中科院分区：
文献类型：
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作者：
Javier Lopez-Longo, Francisco;Oliver-Minarro, Desamparados;Carreno, Luis
Objective.类风湿性关节炎（RA）患者患心血管疾病的风险增加，这可能并不总是与传统的心血管危险因素有关。本研究的目的是确定抗环瓜氨酸肽（抗CCP）抗体是否与RA患者的心血管疾病相关。抗CCP抗体测定酶联免疫吸附试验在最早的血清样本，从937例诊断为RA。我们研究了抗CCP抗体与传统心血管危险因素和心血管事件的关系。抗CCP抗体阳性（>25单位/ml）672例（71.7%）。抗CCP抗体与心血管危险因素如吸烟、高血压、血脂异常、超重或糖尿病之间无相关性。然而，抗CCP抗体阳性的患者发生缺血性心脏病的频率更高（6.5% vs 2.6%;比值比[OR] 2.58，95%置信区间[95% CI] 1.17-5.65），死亡率更高（11.2% vs 6.8%; OR 1.72，95% CI 1.01-2.91）。当我们认为抗CCP滴度高20倍（>5100单位/ml）时，获得了类似的结果。多因素分析显示抗CCP抗体阳性与缺血性心脏病独立相关（OR 2.8，95%CI 1.19-6.56; P = 0.009）。RA患者抗CCP抗体与缺血性心脏病的发生独立相关。
Objective. Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease that may not always be related to the presence of traditional cardiovascular risk factors. The aim of this study was to determine if anti-cyclic citrullinated peptide (anti-CCP) antibodies are associated with cardiovascular disease in patients with RA.Methods. Anti-CCP antibodies were determined by enzyme-linked immunosorbent assay in the earliest serum sample available from 937 patients with a diagnosis of RA. We studied the relationship between anti-CCP antibodies with traditional cardiovascular risk factors and cardiovascular events.Results. We found positive anti-CCP antibodies (>25 units/ml) in 672 patients (71.7%). There was no association between the anti-CCP antibodies and cardiovascular risk factors such as smoking, hypertension, dyslipidemia, being overweight, or diabetes mellitus. However, patients who had positive anti-CCP antibodies experienced more frequent ischemic heart disease (6.5%, versus 2.6%; odds ratio [OR] 2.58, 95% confidence interval [95% CI] 1.17-5.65) and had higher mortality rates (11.2% versus 6.8%; OR 1.72, 95% CI 1.01-2.91). Similar results were obtained when we considered anti-CCP titers 20-fold higher (>5100 units/ml). Multivariable analysis showed that ischemic heart disease is independently associated with positive anti-CCP antibodies (OR 2.8, 95% CI 1.19-6.56; P = 0.009).Conclusion. Anti-CCP antibodies in patients with RA are independently associated with the development of ischemic heart disease.