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Antibodies to citrullinated peptides and risk of coronary heart disease

Geraldine Cambridge1, Jayshree Acharya, Jackie A Cooper

  • 1Division of Rheumatology, Department of Medicine, University College London, 5 University St, London WC1E 6JF, UK. g.cambridge@ucl.ac.uk

Atherosclerosis
|March 12, 2013
PubMed

Insights

Serum antibodies to citrullinated proteins (ACPA) are linked to higher coronary artery disease risk, even without rheumatoid arthritis. This finding suggests ACPA may be a broader biomarker for cardiovascular disease.

Area of Science:

  • Immunology
  • Cardiology
  • Rheumatology

Background:

  • Elevated serum antibodies to citrullinated proteins (ACPA) are associated with increased cardiovascular risk in rheumatoid arthritis (RA) patients.
  • Citrullination is implicated in various chronic inflammatory conditions.

Purpose of the Study:

  • To investigate the association between ACPA and coronary artery disease (CAD) in individuals without RA.
  • To determine if ACPA can serve as a predictive biomarker for cardiovascular events independently of RA.

Main Methods:

  • Retrospective analysis of sera from 3052 healthy male individuals.
  • Longitudinal follow-up for the development of coronary artery disease (myocardial infarction).
  • Matched case-control design (144 cases, 288 controls) with adjustment for cardiovascular risk factors.

Main Results:

  • ACPA positivity was significantly higher in CAD cases (10.4%) compared to controls (3.8%).
  • An odds ratio of 3.26 (p=0.008) for CAD was observed in ACPA-positive individuals.
  • The association remained significant after adjusting for smoking and C-reactive protein (CRP), with an adjusted odds ratio of 4.23 (p=0.02).

Conclusions:

  • ACPA positivity is associated with an increased risk of coronary artery disease in the absence of rheumatoid arthritis.
  • These findings suggest a potential role for ACPA in the pathogenesis or as a biomarker for atherosclerosis.
  • Further research into the origins and specificities of ACPA in atherosclerosis is warranted.
Abstract

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