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Association of apolipoprotein B/apolipoprotein A1 ratio and cardiovascular events in rheumatoid arthritis: results of the CARMA study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24

 

  1. Division of Rheumatology, Hospital de Manises, Valencia, Spain.
  2. Division of Rheumatology, Hospital Universitario Hospital General Virgen de la Concha, Zamora, Spain.
  3. Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
  4. Division of Rheumatology, Consorci Sanitari de Terrassa, Barcelona, Spain.
  5. Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
  6. Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain.
  7. Division of Rheumatology, Hospital Regional Universitario de Málaga, Spain.
  8. Division of Rheumatology, Hospital Universitario La Paz, Madrid, Spain.
  9. Division of Rheumatology, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
  10. Division of Rheumatology, Hospital Universitario de Araba, Vitoria-Gasteiz, Spain.
  11. Division of Rheumatology, Hospital Universitario Los Arcos del Mar Menor, Murcia, Spain.
  12. Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
  13. Division of Rheumatology, Instituto Provincial de Rehabilitación, Madrid, Spain.
  14. Division of Rheumatology, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain.
  15. Division of Rheumatology, Hospital Universitario Severo Ochoa, Madrid, Spain.
  16. Division of Rheumatology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
  17. Division of Rheumatology, Hospital Universitario Virgen de Valme, Sevilla, Spain.
  18. Division of Rheumatology, Hospital Universitario Infanta Leonor, Madrid, Spain.
  19. Division of Rheumatology, Hospital El Escorial, Madrid, Spain.
  20. Division of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
  21. Division of Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  22. University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain.
  23. Division of Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, Cátedra UAM-ROCHE, EPID-Future, Universidad Autónoma (UAM), Madrid, Spain.
  24. University of Cantabria, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander; Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain; and University of the Witwatersrand, Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, South Africa. miguelaggay@hotmail.com

on behalf of the CARMA Project Collaborative Group

CER12324
2020 Vol.38, N°4
PI 0662, PF 0669
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PMID: 31694752 [PubMed]

Received: 12/04/2019
Accepted : 02/09/2019
In Press: 30/10/2019
Published: 28/07/2020

Abstract

OBJECTIVES:
To assess the plasma apolipoprotein B/apolipoprotein A1 ratio and its potential association with cardiovascular events (CVE) in patients with rheumatoid arthritis (RA).
METHODS:
A baseline analysis was made of the CARdiovascular in rheuMAtology Project (CARMA), a 10-year prospective study evaluating the presence of at least one CVE in 775 Spanish patients with RA. Of them, 29 had already experienced CVE prior to the inclusion in the study. We assessed the association between the elevation of the apoB/apoA1 ratio with the presence of CVE according to a logistic regression model for possible confounding factors. We also analysed the main parameters of activity of RA and parameters related to lipid metabolism. RA patients were classified according to treatment: patients treated with disease-modifying anti-rheumatic drugs without biologics and those undergoing biologic therapy (anti-TNF-α, anti-IL-6 receptor, and other biologic agents).
RESULTS:
The apoB/apoA1 ratio of patients who had experienced CVE was higher than that of patients without previous CVE (0.65 vs. 0.60). However, the difference between both subgroups did not reach statistical significance (p=0.197). It was also the case after the multivariate analysis [OR: 1.48 (95% CI: 0.15–14.4); p=0.735]. RA patients from the group with CVE were more commonly receiving lipid-lowering treatment with statins than those without CVE history (41.4% vs. 20%, p=0.005). High HAQ and high atherogenic index were significantly associated with the presence of CVE. There was no statistical association between the type of biologic therapy used in RA and the presence of CVE.
CONCLUSIONS:
No association between ApoB/apoA1 ratio and CVE was found at the baseline visit of patients with RA from the CARMA study.

Rheumatology Article