Significance of Antinuclear Antibodies and Rheumatoid Factor in Patients with Advanced Peripheral Arterial Disease

Objective: To determine whether or not elevated titers of antinuclear antibodies (ANA) and/or rheumatoid factor (RF) are associated with patients with advanced peripheral arterial disease (PAD). Subjects and Methods: A cross-sectional study was done between September 2005 and December 2006. Fifty-eight patients with clinical and angiographic evidence of PAD and 41 controls were studied. Controls had no documented history of peripheral, coronary or cerebral vascular disease. All subjects were screened for metabolic syndrome and C-reactive protein (CRP) as risk factors for peripheral vascular disease. Additionally, all were tested for anti-mitochondrial, anti-neutrophil cytoplasmic and anti-smooth muscle antibodies; those with positive results were excluded. ANA and RF were measured in sera from cases and controls. Results: One case and 3 controls had positive anti-smooth muscle antibodies and were therefore excluded from statistical analysis. Metabolic syndrome was significantly more prevalent in patients than controls (p 0.05). Mean CRP level was 4.78 ± 7.70 and 2.65 ± 3.86 mg/dl in cases and controls, respectively (p = 0.021). ANA were detected at a titer of ≧1:40 in 6 (10.5%) of the advanced PAD patients but none of the controls; the difference was not statistically significant. RF was less prevalent in cases than controls (p 0.05). Conclusion: RF and ANA do not appear to be associated with PAD in a Kuwaiti population.