Highlights from the American College of Rheumatology 2008 Annual Scientific Meeting

Newswise — Rheumatoid Arthritis Patients do Worse After a Heart Attack

Following a heart attack, people with rheumatoid arthritis (RA) suffer greater heart-related complications, including an increased risk for dying, when compared to other heart attack patients, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco.

Mayo Clinic researchers determined that patients with RA do suffer higher mortality and are at higher risk of heart failure after a heart attack, but reasons for the increase are still unknown. The results of this study emphasize the need for better strategies for prevention, diagnosis and treatment of heart attacks in these patients.

"Heart disease can remain silent in those with rheumatoid arthritis, but the risk is there soon after the onset of the disease," explains Hilal Maradit Kremers, M.D., Mayo Clinic epidemiologist and lead author of the study. "Regular cardiac checkups are important -- as are lowering traditional cardiac risk factors, such as taking care of blood pressure and cholesterol and quitting smoking."

Biomarkers Help Determine Most Effective Treatment for Muscle Tissue Inflammation

A recent study conducted at Mayo Clinic and the University of Minnesota, as part of the Minnesota Partnership for Biotechnology and Medical Genomics, has identified pathways that allow doctors to look at biomarkers in the bloodstream to identify disease activity and flare.

The study shows that Interleukin 17, a protein that provides a communications pathway between cells, gives researchers the ability to look at the bloodstream to identify biological markers — distinctive indicators of a process, event or condition. The Type -1 Interferon signature (IFN) is a biomarker in dermatomyositis. The study identified a strong pattern that confirms the combination of these two biomarkers, IL-17 pathway and IFN signature, are a valid indicator of the progress of dermatomyositis.

Dermatomyositis is an autoimmune disease that weakens the muscles and causes muscle and joint pain as well as reddish eruptions on the face, neck and upper torso.

"A goal of this study is to be able to look in the bloodstream to identify biological markers or disease activity," says Ann Reed, M.D., Mayo Clinic pediatric rheumatologist. "How active is the disease and where is it going? We then can determine whether to continue treatment and what treatment will be most effective on a patient-by-patient basis.

"These results also provide us with a link between dermatomyositis and rheumatoid arthritis," says Dr. Reed. "We can apply these same procedures to determine the most effective treatments for rheumatoid arthritis patients."

Insulin-Like Proteins Linked to Age-Related Bone Loss in Men and Women

A recent study conducted at Mayo Clinic suggests that high levels of one of the natural insulin-like proteins involved in regulating tissue growth and maintenance in the body, Insulin-Like Growth Factor Binding Protein-2 (IGFBP-2), also may be an indicator of low bone density and high rates of bone loss in older women and men.

The study concluded that high IGFBP-2 levels affect various bones and various sites of bone differently for older women and men. It provided novel insight on likely differences in the regulation of bone loss, not only by age and gender, but by bone site.

"Adjusting for age, we found no association between IGFBP-2 and bone loss in premenopausal women or men younger than 50," says Shreyasee Amin, M.D., Mayo Clinic rheumatologist. "In postmenopausal women, however, high IGFBP-2 levels were associated with bone loss at all sites except the spine."