Anti-apoA-1 Ups Cardiovascular Risk Prediction in RA

Adding anti-apolipoprotein A-1 IgG to Framingham cardiovascular risk score improves predictive value

WEDNESDAY, Feb. 15 (HealthDay News) -- Adding the biomarker anti-apolipoprotein A-1 IgG (anti-apoA-1) to the 10-year Framingham cardiovascular risk score (FRS) significantly improves prediction of cardiovascular events in patients with rheumatoid arthritis, according to a study published online Feb. 2 in Arthritis Care & Research.

Axel Finckh, M.D., of Geneva University Hospitals, and colleagues conducted a prospective study that followed 118 patients with rheumatoid arthritis, without cardiovascular disease at baseline, for a median of nine years to determine the prognostic accuracy of different biomarkers (C-reactive protein, anti-citrullinated peptide antibodies, rheumatoid factor, N-terminal pro-brain natriuretic peptide [NT-proBNP], oxidized low-density lipoprotein [oxLDL], and anti-apoA-1) in addition to the 10-year FRS for prediction of cardiovascular events.

The researchers found that the incidence of cardiovascular events was 16 percent during follow-up. FRS and NT-proBNP, oxLDL, and anti-apoA-1 were identified as significant predictors of subsequent cardiovascular events, with an area under the receiver operating characteristic curve (AUC) ranging from 0.68 to 0.73. The only biomarker which significantly improved the prognostic ability of FRS was anti-apoA-1, with the AUC increasing from 0.72 to 0.81 and a 175 percent improvement in the integrated discrimination improvement statistic.

"Of the six emergent prognostic biomarkers tested in this study, anti-apoA-1 was the only biomarker to significantly improve the predictive ability of the FRS. Indeed, this combination reached a level of discrimination traditionally deemed sufficient (AUCs > 0.80) to identify patients susceptible to benefit from specific preventive intervention," the authors write.

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