{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:26:10Z","timestamp":1762298770786,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01\u2010HL\u2010127118","K24\u2010AR\u2010055989","P30\u2010AR\u2010072577"],"award-info":[{"award-number":["R01\u2010HL\u2010127118","K24\u2010AR\u2010055989","P30\u2010AR\u2010072577"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Current validated cardiovascular (<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>) risk estimates were developed in populations with relatively stable levels of inflammation, whereas patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) routinely experience significant changes in inflammation. This study was undertaken to test whether changes in inflammation affect estimated <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk as measured using validated population\u2010based risk calculators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants in a prospective <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> cohort who experienced a decrease or an increase of \u226510 mg\/liter in the C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) level at 2 consecutive time points 1 year apart (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> decrease group and <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> increase group, respectively) were included in this study. We estimated 10\u2010year <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk using the following calculators: Framingham Risk Score, 2013 American College of Cardiology\/American Heart Association Atherosclerotic Cardiovascular Disease Risk Score, Reynolds Risk Score (<jats:styled-content style=\"fixed-case\">RRS<\/jats:styled-content>), and <jats:styled-content style=\"fixed-case\">QRISK<\/jats:styled-content>2. Of these calculators, only the <jats:styled-content style=\"fixed-case\">RRS<\/jats:styled-content> includes a variable addressing the <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> level. Paired <jats:italic>t<\/jats:italic>\u2010tests were performed to compare risk scores at baseline and 1\u2010year follow\u2010up. We calculated the correlations between the changes in risk scores and changes in pro\u2013B\u2010type natriuretic peptide (pro <jats:styled-content style=\"fixed-case\">BNP<\/jats:styled-content>), a surrogate marker of <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred eighty <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> patients were included in the study (mean age 57.8 years, 84% female, 80% seropositive). Of the calculators studied, only the <jats:styled-content style=\"fixed-case\">RRS<\/jats:styled-content> was sensitive to changes in inflammation; an increase in inflammation was associated with increased estimated <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk (<jats:italic>P<\/jats:italic> &lt; 0.0001), and only the <jats:styled-content style=\"fixed-case\">RRS<\/jats:styled-content> was correlated with changes in pro<jats:styled-content style=\"fixed-case\">BNP<\/jats:styled-content> (r = 0.17, <jats:italic>P<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data showed no significant change in <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk estimated using validated general population <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk calculators except for the <jats:styled-content style=\"fixed-case\">RRS<\/jats:styled-content>. These findings suggest that <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk may be modulated by changes in inflammation in <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, which is not typically considered when using existing <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> risk calculators.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40532","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T07:29:29Z","timestamp":1524209369000},"page":"1392-1398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of Changes in Inflammation on Estimated Ten\u2010Year Cardiovascular Risk in Rheumatoid Arthritis"],"prefix":"10.1002","volume":"70","author":[{"given":"Zhi","family":"Yu","sequence":"first","affiliation":[{"name":"Brigham and Women's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health 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