High titer of anti-citrullinated peptide antibody is a risk factor for severe carotid atherosclerotic plaque in patients with rheumatoid arthritis: the TOMORROW study
Tadashi Okano
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKentaro Inui
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYuko Sugioka
Center for Senile Degenerative Disorders (CSDD), Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKenichi Sugioka
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYoshiki Matsumura
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShinji Takahashi
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorMasahiro Tada
Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, Japan
Search for more papers by this authorKenji Mamoto
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShigeyuki Wakitani
Department of Health and Sports Sciences, Mukogawa Women's University, Hyogo, Japan
Search for more papers by this authorCorresponding Author
Tatsuya Koike
Center for Senile Degenerative Disorders (CSDD), Osaka City University Graduate School of Medicine, Osaka, Japan
Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Wakayama, Japan
Correspondence: Tatsuya Koike, Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, Asahi-machi Abeno-ku 1–4-3, Osaka 545–8585, Japan. Email: [email protected]Search for more papers by this authorHiroaki Nakamura
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorTadashi Okano
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKentaro Inui
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYuko Sugioka
Center for Senile Degenerative Disorders (CSDD), Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKenichi Sugioka
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYoshiki Matsumura
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShinji Takahashi
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorMasahiro Tada
Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, Japan
Search for more papers by this authorKenji Mamoto
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShigeyuki Wakitani
Department of Health and Sports Sciences, Mukogawa Women's University, Hyogo, Japan
Search for more papers by this authorCorresponding Author
Tatsuya Koike
Center for Senile Degenerative Disorders (CSDD), Osaka City University Graduate School of Medicine, Osaka, Japan
Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Wakayama, Japan
Correspondence: Tatsuya Koike, Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, Asahi-machi Abeno-ku 1–4-3, Osaka 545–8585, Japan. Email: [email protected]Search for more papers by this authorHiroaki Nakamura
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorAbstract
Aim
Cardiovascular disease is one of the complications of rheumatoid arthritis (RA). We researched the morbidity and severity of existing carotid atherosclerosis plaque and associated risk factors in patients with RA.
Method
This study included 413 participants, including 208 patients with RA and 205 age- and sex-matched healthy volunteers. Carotid ultrasound, clinical data collection and assessment of cardiovascular risk factors were performed. Atherosclerotic plaque was defined as an intima-media thickness ≥ 1.1 mm. Severity of plaque was assessed by plaque score, defined as the sum of the maximal thickness of all plaques in bilateral carotid arteries.
Results
Data were analyzed from 200 patients with RA and 202 controls. Carotid plaque was observed more frequently in patients with RA than controls (47.0 vs. 36.1%, P = 0.027). Moreover, plaque score was significantly higher in RA patients (P = 0.032). In logistic regression analysis, RA represented an independent risk factor for the presence of plaque (adjusted odds ratio, 1.68; 95% confidence interval, 1.03–2.74). Comparing RA patients with and without plaque, anti-cyclic citrullinated peptide (anti-CCP) antibodies titer was significantly higher in patients with plaque (315.8 ± 454.1 U/mL) than in patients without (165.7 ± 281.1 U/mL; P = 0.005). Moreover, multiple linear regression analysis clarified that anti-CCP antibody titer was associated with plaque score in patients with RA.
Conclusion
High prevalence of any carotid plaques and severe carotid plaques were more frequent in patients with RA. High titer of anti-CCP antibodies represented a risk factor for severe carotid atherosclerotic plaque in patients with RA.
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