López-Longo Francisco Javier, Oliver-Miñarro Desamparados, de la Torre Inmaculada, González-Díaz de Rábago Eugenia, Sánchez-Ramón Silvia, Rodríguez-Mahou Margarita, Paravisini Alexandra, Monteagudo Indalecio, González Carlos-Manuel, García-Castro Marta, Casas María Dolores, Carreño Luis
Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Arthritis Rheum. 2009 Apr 15;61(4):419-24. doi: 10.1002/art.24390.
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.
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.
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 (>500 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).
Anti-CCP antibodies in patients with RA are independently associated with the development of ischemic heart disease.
类风湿关节炎（RA）患者患心血管疾病的风险增加，这可能并不总是与传统心血管危险因素的存在相关。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。
采用酶联免疫吸附测定法，在937例确诊为RA的患者可获得的最早血清样本中检测抗CCP抗体。我们研究了抗CCP抗体与传统心血管危险因素及心血管事件之间的关系。
我们在672例患者（71.7%）中发现抗CCP抗体阳性（>25单位/毫升）。抗CCP抗体与吸烟、高血压、血脂异常、超重或糖尿病等心血管危险因素之间无关联。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%对2.6%；比值比[OR]2.58，95%置信区间[95%CI]1.17 - 5.65），且死亡率更高（11.2%对6.8%；OR 1.72，95%CI 1.01 - 2.91）。当我们考虑抗CCP滴度高出20倍（>500单位/毫升）时，也得到了类似结果。多变量分析显示，缺血性心脏病与抗CCP抗体阳性独立相关（OR 2.8，95%CI 1.19 - 6.56；P = 0.009）。
RA患者的抗CCP抗体与缺血性心脏病的发生独立相关。
