Objective: Individuals with rheumatoid arthritis (RA) have an increased prevalence of ischaemic heart disease (IHD). This is most likely in those with the autoantibody rheumatoid factor (RF). Rheumatoid factor (RF) is strongly associated with RA but is also present in up to 15% of adults. We hypothesised that RF might identify individuals in a general population who also share an increased likelihood of developing IHD.
Methods: Individuals from the Hertfordshire cohort study were investigated for the presence of RF. Individuals in this study have completed a questionnaire and attended a clinic where a history of IHD was recorded (ECG, CABG, Rose chest pain). We investigated associations between the presence of RF, antinuclear antibodies (ANA), anticardiolipin antibodies (ACA) and IHD in 567 men and 589 women and compared them to traditional risk factors for IHD.
Results: RF was associated with an increased likelihood of IHD in men (OR 3.1, 95%CI 1.7-5.4, p<0.001). This increased risk could not be explained by traditional risk factors for IHD (mutually adjusted OR for RF 2.9 [95%CI 1.6-5.3], p=0.001). There was no significant association between RF in women or between ANA or ACA with IHD in men or women.
Conclusion: This work suggests that RF is an independent risk factor for IHD in the general population. It lends support to the importance of inflammation in atherosclerosis and suggests that autoimmune processes may be involved. In addition, it raises the intriguing possibility that RF may have a direct role in the pathogenesis of IHD in some individuals.
- Rheumatoid factor
- ischaemic heart disease
- risk factors
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