Citrullinated proteins have been found within atherosclerotic plaque. However, to date studies evaluating the association between anti-citrullinated peptide antibodies (ACPAs) and imaging measures of atherosclerosis in patients with rheumatoid arthritis (RA) have been limited to citrullinated-fibrinogen or citrullinated-vimentin seroreactivities and rendered contradictory results. Therefore, our objective was to evaluate this association using an extended panel of ACPAs in a larger sample of RA patients without clinical cardiovascular disease (CVD).ACPAs were identified by a custom Bio-Plex bead assay in 270 patients from two independent RA cohorts without clinical CVD consisting of 195 and 75 patients, respectively. Coronary artery calcium (CAC) was assessed by computed tomography as a measure of coronary artery disease.High levels of anti-citrullinated histone 2B antibodies were strongly associated with higher CAC compared with lower antibody levels (p=0.001); this remained significant after adjusting for traditional CV and RA-specific risk factors (p=0.03). No association between levels of ACPAs and CAC progression at 3 years was seen (p=0.09), however the number of progressors was small (n=92).Higher levels of ACPAs targeting cit-histone 2B were associated with higher CAC scores when compared to lower antibody levels, suggesting a potential role for histone citrullination seroreactivity in atherosclerosis. This article is protected by copyright. All rights reserved.
View details for DOI 10.1002/acr.23106
View details for PubMedID 27696777