Does Cartilage Oligomeric Matrix Protein (COMP) Have a Role in Subclinical Myocardial Fibrosis in Rheumatoid Arthritis Patients?

Background: Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity, partially attributable to subclinical myocardial fibrosis. Cartilage oligomeric matrix protein (COMP), an extracellular matrix glycoprotein, is associated with tissue remodelling and fibrosis. Objective: To investigate the function of serum COMP in identifying subclinical myocardial fibrosis in RA patients and its correlation with electrocardiographic and echocardiographic results. Methods: This cross-sectional study included 60 RA patients and 30 healthy controls. RA patients were categorised into fragmented QRS (fQRS) and normal QRS groups. Serum COMP, inflammatory markers (ESR, C-reactive protein), immunological markers (rheumatoid factor, anti-cyclic citrullinated peptide) and DAS-28 were evaluated. Global longitudinal strain (GLS) was assessed via speckle tracking echocardiography. Results: COMP levels were significantly higher in RA patients compared to controls ( P < .001). Patients with fQRS had significantly elevated COMP levels relative to those with normal QRS ( P < .001). COMP had a strong positive correlation with GLS ( r = 0.778, P < .001). Receiver operating characteristic analysis showed outstanding diagnostic effectiveness (AUC = 0.913) in differentiating between normal QRS and fQRS patients and identifying myocardial involvement. Conclusion: COMP levels are markedly increased in patients with RA and are closely related to subclinical cardiac fibrosis, especially in those with fQRS complexes. It may function as a potential biomarker for the early stratification of cardiovascular risk in RA.