Asmaa Abdulrasool Jaafar None

Rheumatoid arthritis (RA) carries an elevated risk of thrombotic complications, a major contributor to cardiovascular morbidity in this population. This case-control study aimed to identify predictive factors for thrombosis risk in RA and D-dimer roles, focusing on anti-mutated citrullinated vimentin (anti-MCV) antibodies and disease activity. Sixty-five RA patients and 25 age-matched female controls were recruited from Al-Sadder Teaching Hospital, Iraq (September–November 2024). Disease activity was assessed via DAS28-CRP, alongside biomarkers (CRP, ESR, D-dimer, anti-MCV), lipid profiles, and platelet counts. RA patients exhibited significantly elevated CRP (9.19 vs. 2.45 mg/L, p<0.0001), D-dimer (0.66 vs. 0.29 μg/mL, p<0.001), anti-MCV (7.96 vs. 2.63 U/mL, p<0.001), and ESR (38.34 vs. 18.99 mm/hr, p<0.001) compared to controls. Higher disease activity (DAS28-CRP ≥3.25) correlated with older age (OR:7.600; 95%CI:2.173–26.583), elevated CRP (OR:7.000; 95%CI:3.171–15.454), and D-dimer (OR:13.176; 95%CI:2.676–64.879). Anti-MCV levels showed a weaker association (OR:3.846; 95%CI:0.452–32.695, p=0.036). ROC analysis identified CRP (AUC:0.99, sensitivity:100%, specificity:94%) and D-dimer (AUC:0.87) as robust discriminators of moderate-to-high disease activity, while anti-MCV demonstrated poor discriminatory capacity (AUC:0.60, p=0.334). Correlation analyses revealed strong associations between DAS28-CRP and CRP (r=0.871), D-dimer (r=0.792), and ESR (r=0.541), but only a modest link with anti-MCV (r=0.313). In conclusion, systemic inflammation (CRP, D-dimer) and age, rather than anti-MCV, are critical predictors of thrombosis risk in RA. Anti-MCV’s limited discriminatory utility suggests its role in RA pathophysiology may not directly translate to thrombosis risk stratification. These findings underscore the importance of integrating inflammatory biomarkers into RA management protocols to address cardiovascular morbidity.

Abstract Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that increases the risk of thrombotic complications, resulting in higher cardiovascular (CVD) morbidity and mortality. Chronic systemic inflammation, vascular damage, and atherosclerosis significantly elevate CVD risk, further exacerbated by the high disease activity of RA. Objective: Identify diagnostic immunomarkers, such as Anti–Modified Citrullinated Vimentin Antibodies (Anti-MCV), and their relationship with N‐terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) and thrombin-activatable fibrinolysis inhibitor (TAFI) for the early prediction of cardiovascular risk in RA patients. Methodology: This study evaluated immune-related cardio biomarkers and CVD risk in 65 female RA patients and 25 healthy controls. Results: RA patients exhibited significantly higher disease activity and elevated levels of Anti-MCV antibodies, NT-proBNP, TAFI, and CRP, all strongly associated with CVD. Correlation analysis revealed significant positive associations among CRP, Anti-MCV, TAFI, NT-proBNP, and disease activity (DAS28-CRP). Multiple regression identified CRP (B = 0.17, p < 0.001), Anti-MCV (B = 0.208, p = 0.017), and TAFI (B = 0.01, p < 0.001) as significant predictors of NT-proBNP. Logistic regression indicated that age >45 years (OR = 5.25, p = 0.004), CRP >3 mg/L (OR = 6.00, p = 0.020), high disease activity (OR= 4.44, p =0.014), and elevated Anti-MCV, NT-proBNP, and TAFI (OR = 1.27, 2.85, and 1.006 respectively; all p < 0.05) are key CVD risk factors, while low HDL (<40 mg/dL) was protective (OR=0.33, p=0.044). NT-proBNP demonstrated the highest predictive accuracy (AUC=0.84). Conclusion: The significant role of immune activation biomarkers in predicting cardiovascular risk in RA patients. Notably, Anti-MCV, in association with NT-proBNP and TAFI, emerges as a valuable set of indicators for CVD risk assessment.

Discussion of the master's thesis entitled (Predictive Role of Coagulation, Cardiovascular and Inflammatory Markers in Early Detection of Thrombosis Risks Among Women with Rheumatoid (Arthritis