Angiopoietin-2 as A Biomarker For Echocardiographic Abnormalities and Carotid Atherosclerosis In Rheumatoid Arthritis Patients.

Atherosclerosis and cardiovascular diseases (CVD) are increasingly recognised complications of rheumatoid arthritis (RA). Angiopoietin 2 (Ang-2) levels have been associated with clinically overt CVD in general population; we assessed serum Ang-2 levels and its correlation with Echocardiographic abnormalities and carotid intima-media thickness in RA patients. 44 RA patients without clinically overt CVD and 44 healthy controls were assessed by questionnaire and clinical examination. Disease activity score (DAS-28) was calculated. Laboratory investigations included measurement of serum Ang-2, Rheumatoid factor (RF), anti-cyclic citrullinated peptide (Anti-CCP), and C reactive protein (CRP). Doppler Echocardiography and Carotid ultrasonography were done to all patients and controls. Mean age of RA patients was 44.4±9.6 and about (86.4%) 38 were females. Mean levels of Ang-2 was higher in RA patients (17.591±13.9 ng/ml) as compared to controls (7.909 ±4.10 ng/ml) P<0.001 and was significantly elevated in RA patients with left ventricular (LV) diastolic dysfunction (23.53±7.75 ng/ml) than those without dysfunction (14.81±15.33ng/ml), P<0.05 and was significantly elevated in RA patients with carotid intima-media thickness (cITM) >0.6mm (21.12±14.79 ng/ml), P<0.005. Serum Ang-2 correlated positively with disease duration, DAS-28, LV posterior wall thickness, E wave velocity and cIMT. In conclusion, serum Ang-2 level is associated with LV diastolic dysfunction and increased carotid intima-media thickness in RA patients and may be useful biomarker for subclinical CVD and atherosclerosis in RA patients.