Study identifies blood biomarkers to forecast cardiovascular disease risk in rheumatoid arthritis patients

Rheumatoid arthritis impacts approximately 17.6 million people globally and is associated with an increased risk of cardiovascular disease. Assessing cardiovascular risk is difficult in patients with rheumatoid arthritis because standard clinical assessments based on factors like age, cholesterol, and smoking status tend to underestimate cardiovascular risk in individuals with rheumatoid arthritis.

“We think these biomarkers might improve our ability to predict risk and intervene early to help our patients,” said first author Daniel H. Solomon, MD, MPH, chief of the Section of Clinical Sciences in the Division of Rheumatology. “The idea is that if we measure biomarkers that are specific to rheumatoid arthritis, we might be able to better identify those at highest risk of cardiovascular events.”

To identify rheumatoid arthritis-specific biomarkers of cardiovascular risk, the researchers assembled a panel of 24 candidate biomarkers that had been previously shown to be associated with rheumatoid arthritis and systemic inflammation and measured the concentration of these biomarkers in 109 patients with rheumatoid arthritis who were taking part in a randomized clinical trial (the TARGET Trial) to compare the efficacy of two different treatments for rheumatoid arthritis at preventing cardiovascular disease. They measured the biomarkers at the beginning of the study and six months later, imaging the patients’ arteries at each time to assess their arterial inflammation—an indicator of cardiovascular risk.

The findings of the study revealed that six of the 24 biomarkers were associated with increased cardiovascular risk and could be used in predictive models to improve the researchers’ ability to predict increases in arterial inflammation compared to standard clinical indices which are based on factors such as age, sex, cholesterol, blood pressure, diabetes, and smoking.

“Arterial inflammation can predict future cardiovascular disease risk,” said cardiologist and co-author Ahmed Tawakol, MD, the director of Nuclear Cardiology and co-director of the Cardiovascular Imaging Research Center at Massachusetts General Hospital. “If you take a snapshot of a person's blood vessels, the more inflammation that is measured there, the greater the likelihood the person will have progression of their disease, and the greater likelihood that they will have a stroke or a myocardial infarction.”