Abstract
BackgroundRheumatoid Factors (RF) are antibodies directed against the Fc portion of IgG and are involved in clearance of immune complexes. While RF can develop in a wide range of conditions, higher RF levels indicate a greater risk for a severe disease course in Rheumatoid Arthritis (RA) patients including cardiovascular complications and premature death. We investigated whether RF also constitute a risk factor for these outcomes in the general population.MethodsWe included 2,323 participants (46% male, mean age 50 years) free of CVD at baseline in 1972. RF positivity was defined as a score of ≥2 by latex agglutination (scale 0–5). All outcomes during 42-year follow-up were obtained from state-wide registries. The predictive value of RF for coronary heart disease, all cardiovascular disease and all-cause mortality was estimated by adjusted hazard ratios (HR) from Cox regression models.ResultsAfter adjustment for standard risk factors, RF positivity was not predictive of future CHD (HR 1.05, p = 0.61), CVD (HR 1,04, p = 0.63) or mortality (HR 1.03, p = 0.70) in the full CVD-free cohort. In an interaction model, RF in 41 out of 355 participants with an RA history was not predictive of CHD (HR 0.92, p = 0.77) or CVD events (HR 1.15, p = 0.51), but there was a borderline significant association with overall mortality (HR 1.41, CI 0.97–2.04, p = 0.07).ConclusionsRF detected by Latex agglutination do not independently predict future CHD, CVD or death in the general population. However, the presence of RF in the context of a history of RA is associated with a moderate, borderline significant increase in the long term adjusted risk for all-cause mortality.
Highlights
Rheumatoid Factors (RF) are antibodies directed against the Fc portion of IgG and are involved in clearance of immune complexes
A positive RF was associated with a 5% increased risk of coronary heart disease (CHD) events (HR 1.05, 95% Confidence interval (CI) 0.87–1.28, p = 0.61) and a 4% increased risk of cardiovascular disease (CVD) events (HR 1.04, 95% CI 0.89– 1.21, p = 0.63)
A doctor diagnosis of Rheumatoid Arthritis (RA) was associated with a 1% increased risk of CHD events (HR 1.01, 95% CI 0.79–1.28, p = 0.94) and CVD events (HR 1.01, 95% CI 0.83–1.22, p = 0.95)
Summary
Rheumatoid Factors (RF) are antibodies directed against the Fc portion of IgG and are involved in clearance of immune complexes. While RF can develop in a wide range of conditions, higher RF levels indicate a greater risk for a severe disease course in Rheumatoid Arthritis (RA) patients including cardiovascular complications and premature death. Rheumatoid Factors (RF) are a family of polyclonal antibodies directed against the Fc portion of IgG [1]. The functions of RF include immune complex (IC) clearance, complement fixation and antigen uptake by B cells for T cell presentation. Nossent et al BMC Musculoskeletal Disorders (2017) 18:221 whether RF as detected by a routine Latex agglutination assay indicate an increased risk for CHD, CVD and death in a community based cohort of Australian adults with long-term follow-up
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