{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:07:32Z","timestamp":1792868852243,"version":"4.5.0"},"reference-count":71,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,3,4]],"date-time":"2005-03-04T00:00:00Z","timestamp":1109894400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2005,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether systemic inflammation confers any additional risk for cardiovascular death among patients with rheumatoid arthritis (RA), after adjusting for traditional cardiovascular risk factors and comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the population\u2010based data resources of the Rochester Epidemiology Project, we assembled an incidence cohort of all Rochester, Minnesota residents ages \u226518 years who first fulfilled the American College of Rheumatology 1987 criteria for RA between January 1, 1955 and January 1, 1995. All subjects were followed up longitudinally through their complete (inpatient, outpatient) medical records, beginning at age 18 years and continuing until death, migration, or January 1, 2001. Detailed information on the occurrence of various cardiovascular risk factors (personal history of coronary heart disease [CHD], congestive heart failure, smoking, hypertension, dyslipidemia, body mass index [BMI], diabetes mellitus, menopausal status) as well as indicators of systemic inflammation and RA disease severity (rheumatoid factor [RF] seropositivity, erythrocyte sedimentation rate [ESR], joint swelling, radiographic changes, RA nodules, RA complications, RA treatments, disease duration) and comorbidities were collected on all subjects. Causes of death were ascertained from death certificates and medical records. Cox regression models were used to estimate the independent predictors of cardiovascular death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This inception cohort comprised a total of 603 RA patients whose mean age was 58 years, of whom 73% were women. During a mean followup of 15 years, 354 patients died and cardiovascular disease was the primary cause of death in 176 patients. Personal history of CHD, smoking, hypertension, low BMI, and diabetes mellitus, as well as comorbidities, including peripheral vascular disease, cerebrovascular disease, chronic pulmonary disease, dementia, ulcers, malignancies, renal disease, liver disease, and history of alcoholism, were all significant risk factors for cardiovascular death (<jats:italic>P<\/jats:italic> &lt; 0.01 for each). Multivariable Cox regression analyses, controlled for cardiovascular risk factors and comorbidities, revealed that the risk of cardiovascular death was significantly higher among RA patients with at least 3 ESR values of \u226560 mm\/hour (hazard ratio [HR] 2.03, 95% confidence interval [95% CI] 1.45\u20132.83), RA vasculitis (HR 2.41, 95% CI 1.00\u20135.81), and RA lung disease (HR 2.32, 95% CI 1.11\u20134.84).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results indicate that markers of systemic inflammation confer a statistically significant additional risk for cardiovascular death among patients with RA, even after controlling for traditional cardiovascular risk factors and comorbidities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.20878","type":"journal-article","created":{"date-parts":[[2005,3,4]],"date-time":"2005-03-04T15:50:00Z","timestamp":1109951400000},"page":"722-732","source":"Crossref","is-referenced-by-count":718,"title":["Cardiovascular death in rheumatoid arthritis: A population\u2010based study"],"prefix":"10.1002","volume":"52","author":[{"given":"Hilal","family":"Maradit\u2010Kremers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo J.","family":"Nicola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia S.","family":"Crowson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla V.","family":"Ballman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherine E.","family":"Gabriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,3,4]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(05)70201-5"},{"key":"e_1_2_6_4_2","first-page":"2475","article-title":"Comorbidity in arthritis","volume":"26","author":"Gabriel SE","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(05)70202-7"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2707::AID-ART456>3.0.CO;2-M"},{"key":"e_1_2_6_7_2","first-page":"158","article-title":"Survival and cause of death in rheumatoid arthritis: a 25\u2010year prospective followup","volume":"11","author":"Vandenbroucke JP","year":"1984","journal-title":"J Rheumatol"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000174474"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780360804"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370408"},{"key":"e_1_2_6_11_2","first-page":"149","article-title":"Shortening of life span and causes of excess mortality in a population\u2010based series of subjects with rheumatoid arthritis","volume":"13","author":"Myllykangas\u2010Luosujarvi R","year":"1995","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_12_2","first-page":"445","article-title":"Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden","volume":"24","author":"Wallberg\u2010Jonsson S","year":"1997","journal-title":"J Rheumatol"},{"key":"e_1_2_6_13_2","first-page":"1072","article-title":"Longterm mortality outcome in patients with rheumatoid arthritis: early presenters continue to do well","volume":"25","author":"Symmons DP","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/030097400750001770"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00011191"},{"key":"e_1_2_6_16_2","first-page":"45","article-title":"Outcome of rheumatoid arthritis in relation to age and rheumatoid factor at diagnosis","volume":"20","author":"Van Schaardenburg D","year":"1993","journal-title":"J Rheumatol"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.54.10.811"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.4.447"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10419"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.49.6.363"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000054612.26458.B2"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2737::AID-ART460>3.0.CO;2-#"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199704033361409"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.18.1477"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199901143400207"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.4065\/75.4.369"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.21.2124"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican1081-54"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.4065\/71.3.266"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199904)42:3<415::AID-ANR4>3.0.CO;2-Z"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.509"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10705"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_34_2","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/S0025-6196(11)64613-2","article-title":"Validation of death certificate diagnosis of out\u2010of\u2010hospital coronary heart disease deaths in Olmsted County, Minnesota","volume":"75","author":"Goraya TY","year":"2000","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.19.2486"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500230097036"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440420033005"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.17.1855"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197112232852601"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_6_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3294-8_7"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3294-8_6"},{"key":"e_1_2_6_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-2711-1"},{"key":"e_1_2_6_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10089"},{"key":"e_1_2_6_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200203000-00007"},{"key":"e_1_2_6_48_2","first-page":"525","article-title":"Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis","volume":"5","author":"Voigt LF","year":"1994","journal-title":"Epidemiology"},{"key":"e_1_2_6_49_2","first-page":"1511","article-title":"Chronic comorbidity in patients with early rheumatoid arthritis: a descriptive study","volume":"28","author":"Kroot EJ","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_6_50_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.6.640"},{"key":"e_1_2_6_51_2","first-page":"714","article-title":"Consequences of increased systolic blood pressure in patients with osteoarthritis and rheumatoid arthritis","volume":"30","author":"Singh G","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_52_2","first-page":"2562","article-title":"Extent of inflammation predicts cardiovascular disease and overall mortality in seropositive rheumatoid arthritis: a retrospective cohort study from disease onset","volume":"26","author":"Wallberg\u2010Jonsson S","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200105)44:5<1170::AID-ANR200>3.0.CO;2-T"},{"key":"e_1_2_6_54_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf111"},{"key":"e_1_2_6_55_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420101"},{"key":"e_1_2_6_56_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.56.8.463"},{"key":"e_1_2_6_57_2","first-page":"630","article-title":"The effect of smoking on clinical, laboratory, and radiographic status in rheumatoid arthritis","volume":"27","author":"Wolfe F","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_6_58_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200102)44:2<323::AID-ANR49>3.0.CO;2-C"},{"key":"e_1_2_6_59_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03390160062027"},{"key":"e_1_2_6_60_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.8.6.737"},{"key":"e_1_2_6_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)91083-G"},{"key":"e_1_2_6_62_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000017327.69909.FF"},{"key":"e_1_2_6_63_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/35.3.255"},{"key":"e_1_2_6_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01186-5"},{"key":"e_1_2_6_65_2","first-page":"415","article-title":"Cardiovascular mortality in rheumatoid arthritis: how harmful are corticosteroids?","volume":"24","author":"Raynauld J","year":"1997","journal-title":"J Rheumatol"},{"key":"e_1_2_6_66_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10567"},{"key":"e_1_2_6_67_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-1-199401010-00005"},{"key":"e_1_2_6_68_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390213"},{"key":"e_1_2_6_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.7.668"},{"key":"e_1_2_6_70_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010013"},{"key":"e_1_2_6_71_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200003)43:3<473::AID-ANR1>3.0.CO;2-A"},{"key":"e_1_2_6_72_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10202"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.20878","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.20878","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T21:01:52Z","timestamp":1697058112000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.20878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,3]]},"references-count":71,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2005,3]]}},"alternative-id":["10.1002\/art.20878"],"URL":"https:\/\/doi.org\/10.1002\/art.20878","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,3]]}}}