Ab0236 the haptoglobin 2-2 genotype is associated with increased risk of cardiovascular disease in patients with rheumatoid arthritis: a case-control study

Background Traditional risk factors do not fully explain the increased risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). [1] The Hp2-2 genotype is known to confer a lower anti-oxidant and higher inflammation effect when compared to the non Hp2-2 genotype. [2] Objectives This study aims to investigate the association of Hp genotype with CVD in patients with RA. Methods Sixty-nine with CVD cases and 207 gender and ethnicity matched control (without CVD) with allocation of 1:3, were retrieved from the Tan Tock Seng Hospital RA registry from 1 Jan 2000 to 31 Dec 2020. Hp genotype was determined using TaqMan-based real-time polymerase chain reaction (PCR). CVD was examined against demographics, clinical and laboratory variables in univariate models. Associations between Hp genotypes and CVD were analyzed using conditional logistic regression. All analysis was done using Stata version 16.1. Results The prevalence of Hp2-2 genotype was: Group 1 (CVD group): Chinese: 29/57, 50.9%, Indian: 5/5, 100%, and Malay 2/7, 28.6%; Group 2 (Control group): Chinese 80/171, 46.8%, Indian: 10/15, 66.7%, and Malay 11/21, 52.4%). CVD was significantly associated with age, disease duration, disease activity score 28 (DAS28), diabetes, hypertension, hyperlipidemia, Hp 2-2 allele, rheumatoid factor, cyclic citrullinated peptide (CCP), cumulative dose of prednisolone and methotrexate. Hp 2-2 genotype significantly associated with CVD outcomes in the logistic regression model adjusting for age, smoking status, DAS28, diabetes, hypertension, hyperlipidemia, and CCP (adjusted matched odds ratio: 1.13 (95% CI: 1.01 – 1.27); p = 0.033). Conclusion The Hp 2-2 genotype is associated with an increased risk of CVD in patients with RA in the Singapore multi-ethnic Asian cohort. Further epidemiological and mechanistic studies are warranted to understand the role of the Hp-genotype in rheumatoid arthritis. References [1] Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJL, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of the Rheumatic Diseases. 2017;76(1):17-28. [2] Costacou T, Levy AP. Haptoglobin Genotype and Its Role in Diabetic Cardiovascular Disease. Journal of Cardiovascular Translational Research. 2012;5(4):423-35. Acknowledgements We thank Ms Amelia Lim Qiu Ru, and Ms Choong Ying Qi for the assistance with data collection. This work is supported by Tan Tock Seng Hospital FY2021 Pitch-for-Fund Program Grant (Grant ID: PFFP 21-08). Disclosure of Interests None Declared.