Anti-MCV Antibodies and NT-proBNP as Immunological Predictors of Cardiovascular Risk and Their Association with Thrombotic Events in Rheumatoid Arthritis: A Clinical Investigation

Jaafar, Assma A.; Sharba, Intisar R,

doi:10.21608/ejmm.2025.391905.1699

Anti-MCV Antibodies and NT-proBNP as Immunological Predictors of Cardiovascular Risk and Their Association with Thrombotic Events in Rheumatoid Arthritis: A Clinical Investigation

Document Type : New and original researches in the field of Microbiology.

Authors

Department of Biology, Faculty of Science, University of Kufa, Iraq.

10.21608/ejmm.2025.391905.1699

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.

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