FRI0059 SOLUBLE RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS (SRAGE) AND RISK FOR CARDIOVASCULAR DISEASES IN FEMALES WITH RHEUMATOID ARTHRITIS

Abstract

Background: Rheumatoid arthritis (RA) is strongly associated with increased frequency of cardiovascular disease (CVD), which remains the major cause of mortality in these patients. Current CVD risk assessment algorithms have limited predictive value for RA patients. Soluble receptor for advanced glycation end products (sRAGE) has recently emerged as a biomarker of inflammation with an inverse correlation with traditional CVD risk factors as age, hypertension and hypercholesterolemia.1 Objectives: In a cohort of female RA patients with no previous history of CVD, we assessed whether sRAGE levels were associated with increased risk of CVD during a prospective 5 years follow up. Methods: Serum sRAGE levels were measured in 171 female RA patients (median age 53; range 21-71) at the inclusion to the study. The CVD risk was estimated using the Framingham algorithm and both traditional and RA associated risk factors for CVD were measured. All the patients were prospectively followed up to 5 years for new CV events, type II diabetes and medication for hypertension and hyperlipidemia. Statistical analysis was performed to compare CVD risk and actual events in the patients with low sRAGE (<1700 pg/ml). Results: The comparison of patients with low sRAGE (n=125) and normal-high sRAGE (n=46) found no significant differences in frequency of the traditional CVD risk factors including age>60 years (30% vs 41%), overweight (50% vs 41%), smoking (14% vs 11%), incidental hypertension (16% vs 16%) and hypercholesterolemia (56% vs 67%) at baseline and led to similar estimated CVD risk (7.65% vs 8,45%). The RA-related CVD risk factors including disease duration >10years (37% vs 39%), presence of autoantibodies (89% vs 95%), disease activity (DAS28, 46% vs 60%) were also similar in the low-and high sRAGE groups. At 5 years follow up, 11 new CVD events were registered. The events occurred with similar frequency in the low sRAGE and high sRAGE groups (5.6% vs 8.7%). Despite a lack of difference in CVD events, we did observe a significant increase in frequency of new medication for hypertension in the low sRAGE group (21.5% vs. 63%, p=0.01), but not in medication for type II diabetes or statins. Conclusion: In this study, we found no association between serum levels of sRAGE and the estimated CVD risk or actually occurred CVD events in female RA patients.