Autoantibodies put patients on watch list for cardiovascular disease

Both systemic inflammation and immune dysregulation, including autoantibody production, may occur even in the absence of autoimmune rheumatologic diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Immune dysregulation as manifested by the presence of rheumatoid factor (RF) and antinuclear antibodies (ANA) is associated with cardiovascular disease (CVD) and overall mortality both in persons who have a clinically evident rheumatologic disease and in those who do not.

Liang and coworkers examined how ANA, RF, and anticyclic citrullinated peptide (anti-CCP) antibodies relate to CV events (myocardial infarction [MI], heart failure [HF], peripheral vascular disease [PVD]) in persons with and without rheumatologic disease. They tested 6783 persons for RF, 7852 for ANA, and 299 for anti-CCP antibodies.

For persons in both groups, a strongly positive RF titer was a significant predictor of MI, HF, PVD, and death after adjusting for age, sex, calendar year, and comorbidities; a weakly positive RF conferred no increased CV risk. ANA positivity was a strong predictor of CVD, regardless of titer, before and after adjusting for rheumatologic disease. Anti-CCP antibodies had a positive but statistically insignificant association with CVD.

The authors noted that more investigations about the role of autoantibodies in the pathogenesis of atherosclerosis and CVD are needed.