title: The relationship between rheumatoid factor levels and coronary artery lesion complexity and severity in patients with stable coronary artery disease.
abstract: BACKGROUND
  The relation between serum rheumatoid factor levels and the extent, severity, and complexity of coronary artery disease has not been adequately studied.
  
  
  OBJECTIVE
  Therefore, we assessed the relationship between the severity of coronary artery disease assessed by SYNTAX score and serum rheumatoid factor levels in patients with stable coronary artery disease.
  
  
  METHODS
  We enrolled 268 consecutive patients who underwent coronary angiography. Patients with acute coronary syndrome and chronic immune disorders were excluded. Baseline serum rheumatoid factor levels were measured and the SYNTAX score was calculated from the study population.
  
  
  RESULTS
  Patients were divided into two groups. Group 1 was defined as low SYNTAX score < 22, and group 2 was defined as intermediate and high SYNTAX score > 22. Serum rheumatoid factor levels were significantly higher in the intermediate and high-SYNTAX score group than in the low-SYNTAX score group (16.4 ±9 IU/mlvs. 11.36 ±5 IU/ml, p < 0.001). Also, there was a significant correlation between rheumatoid factor and CRP levels with the SYNTAX score r = 0.411; p < 0.001 and r = 0.275; p < 0.001, respectively. On multivariate linear regression analysis, rheumatoid factor (β = 0.101, p < 0.001) was an independent risk factor for intermediate and high SYNTAX score in patients with stable coronary artery disease. In receiver operator characteristic curve analysis, optimal cut-off value of rheumatoid factor to predict high SYNTAX score was found to be 10.5 IU/ml, with 69% sensitivity and 61% specificity.
  
  
  CONCLUSIONS
  The rheumatoid factor level was independently associated with the extent, complexity, and severity of coronary artery disease assessed by SYNTAX score in patients with stable coronary artery diseases.
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Elnur
authors.initials: E
authors.lastname: Alizade
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Anıl
authors.initials: A
authors.lastname: Avcı
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Göksel
authors.initials: G
authors.lastname: Açar
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Fidan
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Lütfi
authors.initials: L
authors.lastname: Öcal
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Tellice
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akçakoyun
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.affiliation: Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
keywords: SYNTAX score; autoantibodies; inflammation; rheumatoid factor
references.citation: Am J Pathol. 2005 Oct;167(4):1139-48
references.pmid: 16192648
references.citation: Clin Dev Immunol. 2004 Sep-Dec;11(3-4):221-6
references.pmid: 15559367
references.citation: J Rheumatol. 2000 Aug;27(8):1839-47
references.pmid: 10955322
references.citation: Ann Rheum Dis. 2002 Feb;61(2):110-4
references.pmid: 11796395
references.citation: J Rheumatol. 2003 Jan;30(1):36-40
references.pmid: 12508387
references.citation: Atherosclerosis. 2005 Jan;178(1):173-7
references.pmid: 15585215
references.citation: Atherosclerosis. 2012 Apr;221(2):596-601
references.pmid: 22369933
references.citation: Arthritis Rheum. 2005 Feb;52(2):378-81
references.pmid: 15692995
references.citation: Immunol Res. 2004;30(3):261-77
references.pmid: 15531769
references.citation: Circulation. 2005 Nov 22;112(21):3337-47
references.pmid: 16301360
references.citation: N Engl J Med. 2009 Mar 5;360(10):961-72
references.pmid: 19228612
references.citation: Ann Rheum Dis. 2010 Sep;69(9):1649-54
references.pmid: 19628821
references.citation: Ann Rheum Dis. 2002 Feb;61(2):97-9
references.pmid: 11796391
references.citation: J Interv Cardiol. 2011 Aug;24(4):302-6
references.pmid: 21722184
references.citation: Int J Cardiol. 2013 Jul 1;166(3):572-83
references.pmid: 22727974
references.citation: Am J Med. 2004 Oct 1;117(7):499-507
references.pmid: 15464707
references.citation: Heart. 2007 Oct;93(10):1263-7
references.pmid: 17550930
references.citation: N Engl J Med. 2005 Apr 21;352(16):1685-95
references.pmid: 15843671
references.citation: N Engl J Med. 1999 Jan 14;340(2):115-26
references.pmid: 9887164
references.citation: EuroIntervention. 2005 Aug;1(2):219-27
references.pmid: 19758907
references.citation: Annu Rev Immunol. 2004;22:361-403
references.pmid: 15032582
references.citation: Circulation. 2000 Nov 21;102(21):2576-81
references.pmid: 11085959
references.citation: N Engl J Med. 2000 Mar 23;342(12):836-43
references.pmid: 10733371
references.citation: J Chronic Dis. 1967 Jun;20(6):351-69
references.pmid: 5298089
references.citation: Med Princ Pract. 2010;19(3):192-5
references.pmid: 20357501