{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:39:34Z","timestamp":1793392774201,"version":"4.5.0"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec id=\"ab-ioi230046-4\"><jats:title>Importance<\/jats:title><jats:p>Although an increased risk of ischemic cardiovascular disease has been associated with rheumatoid arthritis (RA), the risk of aortic stenosis (AS) is unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-5\"><jats:title>Objective<\/jats:title><jats:p>To examine the risk of incident AS, aortic valve intervention, AS-related death, and risk factors for AS development in patients with RA.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study linked data from the Veterans Health Administration (VHA) and Centers for Medicare &amp;amp;amp; Medicaid Services from 2000 to 2019. Patients with RA were matched by age, sex, and VHA enrollment year with up to 10 patients without RA. The cohort was followed until incident AS, aortic valve intervention, or death. Data were analyzed from August 23, 2022, to March 3, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-7\"><jats:title>Exposures<\/jats:title><jats:p>the primary exposure was the presence of RA, defined using validated RA algorithms.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Aortic stenosis was defined as a composite of inpatient or outpatient diagnoses, surgical or transcatheter aortic valve replacement, or AS-related death using diagnostic and procedural codes. Risk of AS development was assessed with multivariable Cox proportional hazards models adjusted for race, ethnicity, smoking status, body mass index, rurality, comorbidities, and health care use.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-9\"><jats:title>Results<\/jats:title><jats:p>The cohort included 73\u202f070 patients with RA (64 008 [87.6%] males; mean [SD] age, 63.0 [11.9] years) matched with 639\u202f268 patients without RA (554 182 [86.7%] males; mean [SD] age, 61.9 [11.7] years) and 16\u202f109 composite AS outcomes that occurred over 6\u202f223\u202f150 person-years. The AS incidence rate was 3.97 (95% CI, 3.81-4.13) per 1000 person-years in patients with RA and 2.45 (95% CI, 2.41-2.49) per 1000 person-years in the control patients (absolute difference, 1.52 per 1000 person-years). Rheumatoid arthritis was associated with an increased risk of composite AS (adjusted hazard ratio [AHR], 1.48; 95% CI, 1.41-1.55), aortic valve intervention (AHR, 1.34; 95% CI, 1.22-1.48), and AS-related death (AHR, 1.26; 95% CI, 1.04-1.54).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230046-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, RA was associated with a higher risk of developing AS and the subsequent risks of undergoing aortic valve intervention and suffering from AS-related death. Future studies are needed to confirm whether valvular heart disease, specifically AS, may be an overlooked cardiovascular disease complication in RA.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.3087","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T15:32:41Z","timestamp":1690817561000},"page":"973","source":"Crossref","is-referenced-by-count":30,"title":["Aortic Stenosis Risk in Rheumatoid Arthritis"],"prefix":"10.1001","volume":"183","author":[{"given":"Tate M.","family":"Johnson","sequence":"first","affiliation":[{"name":"Medicine & Research Service, VA Nebraska-Western Iowa Health Care System, Omaha"},{"name":"Division of Rheumatology & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetaj A.","family":"Mahabir","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyuna","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punyasha","family":"Roul","sequence":"additional","affiliation":[{"name":"Division of Rheumatology & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Goldsweig","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Baystate Medical Center, Springfield, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce A.","family":"Binstadt","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology, Allergy, and Immunology, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania"},{"name":"Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Sauer","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Salt Lake City VA Medical Center, Salt Lake City, Utah"},{"name":"Division of Rheumatology, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant W.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Salt Lake City VA Medical Center, Salt Lake City, Utah"},{"name":"Division of Rheumatology, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"Medicine & Research Service, VA Nebraska-Western Iowa Health Care System, 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