{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:03:56Z","timestamp":1789581836014,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) confers substantially elevated cardiovascular disease (CVD) risk. We quantified the association between joint risk factor control and incident CVD among RA patients and examined modification by genetic susceptibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this prospective UK Biobank cohort, 4426 RA patients and 17 704 matched non-RA controls were followed for CVD, coronary heart disease (CHD), stroke, and heart failure. A nine-component risk factor control score (0\u20139) was constructed, incorporating healthy diet, smoking, physical activity, blood pressure, glycated haemoglobin, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, body mass index, and estimated glomerular filtration rate. Cox models, sensitivity analyses, and restricted mean survival time (RMST) were applied. Least absolute shrinkage and selection operator regression identified CVD-predictive metabolomic features; mediation analysis quantified the metabolomic risk score (MRS) contribution. Polygenic risk score joint analyses assessed genetic effect modification. Better control was associated with graded CVD risk reduction [moderate: hazard ratio (HR) 0.77, 95% CI: 0.64\u20130.93; high: HR 0.46, 95% CI: 0.33\u20130.64 vs. low]. High control yielded CVD and CHD risks comparable to non-RA controls and lower stroke risk (HR 0.34, 95% CI: 0.13\u20130.91). RMST showed +3.58 CVD-free years (95% CI: 2.49\u20134.68; P &amp;lt; 0.001). Mediation indicated partial MRS mediation (indirect proportion 34.1%; 20.8% adjusted). No significant interaction with MRS; high control attenuated risk even in high genetic risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Comprehensive control attenuates and may offset RA-excess CVD risk, even with high genetic susceptibility. The effect is partially metabolically mediated yet independent of metabolic status, supporting dual-pathway prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag467","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:32:27Z","timestamp":1788521547000},"source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive risk factor control attenuates excess cardiovascular risk in rheumatoid arthritis: a prospective cohort study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1234-544X","authenticated-orcid":false,"given":"Hongxuan","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Cardiology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University , Beijing 102218 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Zi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Second Hospital of Shanxi Medical University , 382 Wuyi Road, Taiyuan, Shanxi 030001 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianjiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan 629000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8207-7367","authenticated-orcid":false,"given":"Boda","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University , Beijing 102218 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0817-7946","authenticated-orcid":false,"given":"Caihong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Second Hospital of Shanxi Medical University , 382 Wuyi Road, Taiyuan, Shanxi 030001 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7400-0718","authenticated-orcid":false,"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan 629000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"2026091613363963500_zwag467-B1","doi-asserted-by":"crossref","first-page":"18001","DOI":"10.1038\/nrdp.2018.1","article-title":"Rheumatoid arthritis","volume":"4","author":"Smolen","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"2026091613363963500_zwag467-B2","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1136\/annrheumdis-2013-204627","article-title":"The global burden of rheumatoid arthritis: estimates from the Global 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