Diagnostic and prognostic role of serum interleukin-6 and carotid ultrasonography to detect subclinical atherosclerosis in patients with RA and ANCA-associated vasculitis

Velichka Popova; Mariela Geneva-Popova; Stanislava Popova-Belova; Mladen Doykov; Stanislav Valkanov; Zguro Batalov; Aleksandar Marinkov; Rositsa Karalilova

doi:10.1007/s00296-024-05568-7

Diagnostic and prognostic role of serum interleukin-6 and carotid ultrasonography to detect subclinical atherosclerosis in patients with RA and ANCA-associated vasculitis

Rheumatol Int. 2024 Mar 30. doi: 10.1007/s00296-024-05568-7. Online ahead of print.

Authors

Velichka Popova¹, Mariela Geneva-Popova², Stanislava Popova-Belova², Mladen Doykov³, Stanislav Valkanov³, Zguro Batalov², Aleksandar Marinkov², Rositsa Karalilova²

Affiliations

¹ Department of Rheumatology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria. drvpopova@gmail.com.
² Department of Rheumatology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria.
³ Department of Urology and General Medicine, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria.

PMID: 38554194
DOI: 10.1007/s00296-024-05568-7

Abstract

ANCA-associated vasculitis (AAV) can affect multiple organs with severe life-threatening manifestations. Disease monitoring is difficult due to a lack of defined biomarkers. We aimed to assess the diagnostic role of serum interleukin-6 and vascular ultrasonography in AAV and subclinical atherosclerosis. The study included 20 AAV patients and two control groups of 34 patients with rheumatoid arthritis (RA) and 35 healthy controls. The levels of Il-6, carotid intima-media thickness test (CIMT), atherosclerotic plaque, and degree of stenosis were investigated. A GRACE-risk score was calculated for AAV and RA patients. The AAV patients had elevated levels of IL-6 (115 ± 23.96) compared to the RA patients (91.25 ± 42.63) and the healthy controls (15.65 ± 3.30), p < 0.001. IL-6 showed a diagnostic accuracy of 73% in distinguishing AAV from RA patients (AUC = 0.730; 95% CI 0.591 to 0834). In the AAV group, CIMT was 1.09, above the upper reference value of 0.90, p < 0.001. The AAV patients had a higher median GRACE risk score, and 60% of them had a high risk of cardiovascular events as compared to 35% of the RA patients. Sonography of extracranial vessels and serum levels of IL-6 can be used in daily clinical practice to diagnose and monitor patients with AAV.

Keywords: ANCA-associated vasculitis (AAV); Carotid intima-media thickness (CIMT); Eosinophilic granulomatosis with polyangiitis (EGPA); GRACE risk score; Granulomatosis with polyangiitis (GPA); Interleukin 6 (IL-6); Microscopic polyangiitis (MPA); Rheumatoid arthritis (RA).