{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:29:32Z","timestamp":1788449372031,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"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":["M01-RR000056"],"award-info":[{"award-number":["M01-RR000056"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["UL1\u2010TR\u2010000040"],"award-info":[{"award-number":["UL1\u2010TR\u2010000040"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["UL1\u2010TR\u2010001079"],"award-info":[{"award-number":["UL1\u2010TR\u2010001079"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR\u2010056116"],"award-info":[{"award-number":["AR\u2010056116"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR\u2010050026"],"award-info":[{"award-number":["AR\u2010050026"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"Objective<\/jats:title>Rheumatoid arthritis (RA<\/jats:styled-content>) patients with the lowest circulating low\u2010density lipoprotein (LDL<\/jats:styled-content>) concentrations are at heightened risk of cardiovascular events. However, the atherosclerosis burden within this subgroup is unknown.<\/jats:p><\/jats:sec>Methods<\/jats:title>RA<\/jats:styled-content> patients pooled from 4 cohort studies of cardiovascular disease (CVD<\/jats:styled-content>; n = 546) were compared with non\u2010RA<\/jats:styled-content> controls from the Multi\u2010Ethnic Study of Atherosclerosis (n = 5,279). Those taking lipid\u2010lowering medications were excluded. Differences in cardiac computed tomography\u2013derived Agatston coronary artery calcium (CAC<\/jats:styled-content>) scores between the RA<\/jats:styled-content> and control groups were compared across strata of LDL<\/jats:styled-content> concentration.<\/jats:p><\/jats:sec>Results<\/jats:title>Among those with low LDL<\/jats:styled-content> concentrations (<70 mg\/dl), mean adjusted CAC<\/jats:styled-content> scores were >4\u2010fold higher for RA<\/jats:styled-content> patients than for controls (18.6 versus 4.6 Agatston units, respectively; P<\/jats:italic> < 0.001), a difference significantly greater than that in any other LDL<\/jats:styled-content> concentration stratum except LDL<\/jats:styled-content> concentration \u2265160 mg\/dl. Similarly, 32% of the RA<\/jats:styled-content> patients with low LDL<\/jats:styled-content> concentration had a CAC<\/jats:styled-content> score of \u2265100 Agatston units compared with only 7% of controls in the same LDL<\/jats:styled-content> concentration stratum (odds ratio 5.97; P<\/jats:italic> < 0.001), a difference significantly greater than that in all of the other LDL<\/jats:styled-content> concentration strata. Low LDL<\/jats:styled-content> concentration was most strongly associated with higher CAC<\/jats:styled-content> score among RA<\/jats:styled-content> patients who were white, had ever smoked, or were not obese. Other than a higher frequency of current smokers, RA<\/jats:styled-content> patients with low LDL<\/jats:styled-content> concentrations did not have more CVD<\/jats:styled-content> risk factors or higher measures of RA<\/jats:styled-content> disease activity or severity than RA<\/jats:styled-content> patients with higher LDL<\/jats:styled-content> concentrations.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>RA<\/jats:styled-content> patients with low LDL<\/jats:styled-content> concentration may represent a group for whom heightened screening and prevention of atherosclerotic CVD<\/jats:styled-content> is appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40889","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T15:14:06Z","timestamp":1552922046000},"page":"1426-1436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Exploring the Lipid Paradox Theory in Rheumatoid Arthritis: Associations of Low Circulating Low\u2010Density Lipoprotein Concentration With Subclinical Coronary Atherosclerosis"],"prefix":"10.1002","volume":"71","author":[{"given":"Jon T.","family":"Giles","sequence":"first","affiliation":[{"name":"Columbia University New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Chester M.","family":"Wasko","sequence":"additional","affiliation":[{"name":"Allegheny Health Network Temple University School of Medicine Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5908-9423","authenticated-orcid":false,"given":"Cecilia P.","family":"Chung","sequence":"additional","affiliation":[{"name":"Vanderbilt University Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moyses","family":"Szklo","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger S.","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Kao","sequence":"additional","affiliation":[{"name":"EMD Serono Research & Development Institute, Inc. 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