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Longitudinal analyses were restricted to those with CAC reassessed at four years (58 patients with RA, 352 controls). CAC was quantified by computed tomography (Agatston method). Incidence was defined as new CAC among those with baseline zero CAC; progression used Berry criteria. Multivariable regression models were hierarchically adjusted. Nonparametric bootstrap estimated 95% confidence intervals (CIs) for progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean \u00b1\u2009SD age was 51.5\u2009\u00b1\u20098.9 years; 55.5% were female. RA was not associated with CAC prevalence (odds ratio [OR] 1.34; 95% CI 0.69\u20132.55) or incidence (OR 0.83; 95% CI 0.05\u20133.08) after adjustment. Conversely, RA was associated with CAC progression after multivariable adjustment (Model 1 OR 3.11; 95% bootstrap CI 1.52\u20138.41; Model 2 OR 4.29; 95% bootstrap CI 1.98\u201314.65).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, RA was associated with CAC progression despite no association with prevalence or incidence. These findings suggest chronic inflammation may drive calcification progression through nontraditional pathways, supporting longitudinal cardiovascular monitoring in RA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80083","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:20:28Z","timestamp":1778505628000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rheumatoid Arthritis and Coronary Artery Calcium Progression: A Case Cohort Analysis From\n                    <scp>ELSA<\/scp>\n                    \u2010Brasil"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2871-8992","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Fonseca Estrada","sequence":"first","affiliation":[{"name":"Clinical and Epidemiological Research Center, University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1005-6715","authenticated-orcid":false,"given":"Marcos","family":"Rafael N. Cavalcante","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Center, University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3212-8466","authenticated-orcid":false,"given":"Itamar","family":"de Souza Santos","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Center, University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3711-1754","authenticated-orcid":false,"given":"M\u00e1rcio","family":"S. Bittencourt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Pittsburgh  Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2787-6841","authenticated-orcid":false,"given":"Vandrize","family":"Meneghini","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Center, University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4856-8450","authenticated-orcid":false,"given":"Paulo","family":"A. Lotufo","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Center, University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1076-5210","authenticated-orcid":false,"given":"Alessandra","family":"C. 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