IMPROVEMENT OF MYOCARDIAL FUNCTION AND DYNAMICS THE LEVEL OF BLOOD BIOMARKERS IN PATIENTS WITH RHEUMATOID ARTHRITIS ON ANTIRHEUMATIC THERAPY

Abstract

TYPE: Late Breaking Abstract TOPIC: Cardiovascular Disease PURPOSE: to study the dynamics of myocardial dysfunction (lower global longitudinal epicardial strain of left ventrical (GLESLV)), pentraxin, galectin-3 and ST2 levels after biological therapy during 12 month follow-up. METHODS: A total of 19 pts with RA (EULAR) were included: 84% of women, age 53[37;65] years, disease duration 19[8;96] months; DAS28 6,0[5.3;6.8], positive for ACCP (89%), RF (78%), without prior administration of biologic therapy (BT) and CVD. All pts underwent blood pressure monitoring, echocardiography and speckle tracking assessment of GLES LV. Methotrexate therapy was started in 68% pts, leflunomide–2%, glucocorticoids–32%. BT was administered in all RA pts (adalimumab and abatacept). After 12 months 21% of RA pts remained highly disease active. ST2, pentraxin and galectin-3 levels was assessed in 19 pts with RA before and after 12 months of BT. RESULTS: After 12 months GLESLV has increased from -15,9[-14,3;-18,5]% to -18,8[-16,0;-21,0]%,(p<0,04); ST2 level decreased from 13,8[11,5;20,1] to 12,5[9,6;14,5]ng/ml, (p<0,003). The incidence rate of lower GLESLV decreased by 41% (from 67% to 26%, p<0.008), There were no significant changes in the pentraxin and galectin-3 levels in RA pts after BT. After 12 months RA pts with preserved high disease activity had higher level of systolic blood pressure (120[100;130] vs 100[92;117]mm Hg,p<0.001), lower LV ejection fraction (58[56;63] vs 68[60;69]%,p<0.05) and GLESLV (-16,8[-15,0;-18,8]% vs -20,1[-18,0;-21,1]%,p<0.05), than in pts whose disease activity decreased. There were negative correlation between ΔGLESLV and ΔESR (r=-0,4;p<0,03), ΔST2 (r=-0,4;p<0,05). CONCLUSIONS: In RA pts decrease disease activity on BT leads to an improvement in GLESLV and pronounced reduction ST2 levels. CLINICAL IMPLICATIONS: That can contribute to reduce the risk of CVD. DISCLOSURE: No significant relationships.