# Rheumatoid Arthritis and the Risk of Cardiovascular Disease: Biomarkers Risk Prediction and Underlying Mechanisms

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $774,845

## Abstract

PROJECT ABSTRACT
 Inflammation contributes substantially to atherosclerotic cardiovascular disease (CVD) in the general
population. Epidemiology, basic science and randomized clinical trial data support the importance of this
relationship. Patients with systemic inflammatory conditions, such as rheumatoid arthritis (RA), can provide
important insights into this relationship because of their more extreme systemic inflammatory phenotype.
Investigators have appreciated the elevated risk of CVD experienced by RA patients: the risk of MI and stroke
are both elevated in RA compared with the general population, contributing to a shortened lifespan. CVD risk
stratification in RA is imprecise and general population tools are not accurate. Most attempts at improving CVD
risk stratification have added clinical RA factors to existing population risk tools. Easily assessed protein
biomarkers would likely enhance CVD risk prediction. The literature strongly suggests relationships between >
20 biomarkers shared by RA and CVD. These relationships have never been studied systematically across
diseases. The overarching goal of this proposal is to identify protein biomarkers for CVD in RA patients,
leveraging the structure of a controlled trial and rigorous methods for deriving and validating a risk score. We
complement the robust biomarker analyses with high-dimensional cellular immuneprofiling, which has the
potential to link specific cell types mechanistically to protein biomarkers and to identify new cellular biomarkers.
 We conducted a randomized controlled trial, the TARGET trial, to examine whether specific treatments
for RA produce reductions in CV risk as measured by FDG PET/CT. This trial, funded by NIH (U01 AR068043)
allowed us to prospectively characterize RA patients, collect biospecimens before and after treatment, and
conduct baseline and 24-week FDG PET/CT scans to assess vascular inflammation. Analyses are still ongoing
to determine whether different RA treatments translate into differential changes in CV risk. We propose to
leverage the TARGET study cohort, dataset and biorepository for the following aims. Aim 1: To use a
comprehensive biomarker panel to derive and validate a CV risk score for patients with RA. The TARGET trial
provides biospecimens, patient phenotypes, and a broad biomarker discovery panel that will have been run as
an in-kind donation. We hypothesize that adding biomarkers to the Pooled Cohort Equation and variables
related to RA disease activity will significantly improve prediction of CV outcomes in RA patients. Aim 2: To
elucidate cellular immune mechanisms linking RA and CVD through scRNA-seq profiling. We will use single
cell transcriptomic and surface proteomics (CITE-seq) to study PBMCs from a subset of TARGET patients,
including both responders and non-responders based on FDG PET/CT, to identify circulating immune cell
populations associated with CV risk and CV biomarkers. We hypothesize that specific immune cell populat...

## Key facts

- **NIH application ID:** 10863851
- **Project number:** 5R01HL163580-03
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Daniel Hal Solomon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $774,845
- **Award type:** 5
- **Project period:** 2022-06-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10863851

## Citation

> US National Institutes of Health, RePORTER application 10863851, Rheumatoid Arthritis and the Risk of Cardiovascular Disease: Biomarkers Risk Prediction and Underlying Mechanisms (5R01HL163580-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10863851. Licensed CC0.

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