Six biomarkers could predict CVD risk in patients with rheumatoid arthritis
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Key takeaways:
- Six biomarkers correlated with changes in CV risk in patients with rheumatoid arthritis.
- More study of these biomarkers is needed in populations where CV events are measured.
Six biomarkers were associated with baseline and treatment-associated changes in arterial inflammation in patients with rheumatoid arthritis and could be used to predict CVD risk in that population, researchers reported.
“Cardiovascular disease is more common in people with rheumatoid arthritis (RA) than the general population. However, our current risk models don’t work as well in RA as they do in non-RA general population patients. This makes it hard to know which people with RA to consider preventive strategies,” Daniel H. Solomon, MD, MPH, chief of the section of clinical sciences in the division of rheumatology and Matthew H. Liang Distinguished Chair at Brigham and Women’s Hospital, told Healio. “As well, we do not have a great handle on why people with RA are at higher cardiovascular risk than the general population. These factors drove us to look at biomarkers that might help predict cardiovascular disease and give us insights into mechanisms underpinning this risk.”
Solomon and colleagues analyzed data from 109 patients with RA (median age, 58 years; 82% women) but without known CVD from the TARGET trial who underwent 18F-fluorodeoxyglucose (FDG) PET/CT scans and had 24 biomarkers assessed at baseline and at 24 weeks. The findings were published in the Journal of the American Heart Association.
Baseline values of the following biomarkers were associated with significant change in arterial target to background ratio:
- serum amyloid A;
- C-reactive protein;
- soluble tumor necrosis factor receptor 1;
- adiponectin;
- chitinase-3-like protein 1, also known as YKL-40; and
- osteoprotegerin.
When the researchers added those six biomarkers to clinical variables from the pooled cohort equation, fit improved, with adjusted R2 rising from 0.2 to 0.33 (likelihood ratio P = .0005).
“These promising six biomarkers need to be studied in larger populations of RA patients where actual cardiovascular events were measured,” Solomon told Healio. “Our current paper relied on PET scans, which are a good marker of cardiovascular risk, but not perfect. These next steps are currently ongoing in our research group. Prompt, aggressive disease control in RA is critical for managing cardiovascular risk.”
For more information:
Daniel H. Solomon, MD, MPH, can be reached at dsolomon@bwh.harvard.edu.
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