{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:44:42Z","timestamp":1753883082855,"version":"3.41.2"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,6,4]]},"abstract":"\n Background<\/jats:title>\n Rheumatic diseases are related to both abnormal bone turnover and atherogenesis, but a mechanistic link was missing.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We investigated the effect of cumulative rheumatic inflammation (\n CRI<\/jats:styled-content>\n ) on risk of coronary calcification in a retrospective cohort of 145 rheumatoid arthritis patients. A time\u2010adjusted aggregate\n CRI<\/jats:styled-content>\n score was derived by conglomerating all quarterly biomarker encounters of serum C\u2010reactive protein over 60\u00a0months immediately preceding computed tomography coronary angiography. Flow cytometry was performed to measure the osteocalcin\u2010positive (\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n )\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n and\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n circulating endothelial progenitor cells (\n EPCs<\/jats:styled-content>\n ). Conventional early circulating\n EPCs CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 133\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n was determined. Coronary calcification was defined as any Agatston score >0.\u00a050% of patients (n=72\/145) had coronary calcification.\n CRI<\/jats:styled-content>\n score was associated with presence of coronary calcification (\n P<\/jats:italic>\n =0.004) (multivariable\u2010adjusted: highest versus lowest quartile: odds ratio=5.6 [95%\n CI<\/jats:styled-content>\n 1.1\u201328.9],\n P<\/jats:italic>\n =0.041). Receiver operating characteristics curve revealed divergent behavior of\n OCN<\/jats:styled-content>\n \u2010expressing circulating\n EPCs<\/jats:styled-content>\n (\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n EPCs<\/jats:styled-content>\n : area under the curve=0.60,\n P<\/jats:italic>\n =0.034;\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n EPCs<\/jats:styled-content>\n : area under the curve=0.59,\n P<\/jats:italic>\n =0.053, positive predictors) versus conventional early\n EPCs<\/jats:styled-content>\n (\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 133\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n : area under the curve=0.60,\n P<\/jats:italic>\n =0.034, negative predictor) for coronary calcification, which persisted after multivariable adjustments (\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n [>75th percentile]: odds ratio=7.2 [95%\n CI<\/jats:styled-content>\n 1.8\u201327.9],\n P<\/jats:italic>\n =0.005;\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n EPCs<\/jats:styled-content>\n [>75th percentile]: odds ratio=6.0 [95%\n CI<\/jats:styled-content>\n 1.5\u201323.3],\n P<\/jats:italic>\n =0.010;\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 133\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n [>75th percentile: odds ratio=0.3 [95%\n CI<\/jats:styled-content>\n 0.1\u20131.0],\n P<\/jats:italic>\n =0.053). Intriguingly, the\n CRI<\/jats:styled-content>\n score was associated with increased\n OCN<\/jats:styled-content>\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n EPCs<\/jats:styled-content>\n (highest versus lowest quartile: B=+25.6 [95%\n CI<\/jats:styled-content>\n 0.8\u201350.5] [\u00d710\n 3<\/jats:sup>\n \/mL peripheral blood],\n P<\/jats:italic>\n =0.043), but reduced\n CD<\/jats:styled-content>\n 34\n +<\/jats:sup>\n CD<\/jats:styled-content>\n 133\n +<\/jats:sup>\n KDR<\/jats:styled-content>\n +<\/jats:sup>\n EPCs<\/jats:styled-content>\n (highest versus lowest quartile: B=\u221216.2 [95%\n CI<\/jats:styled-content>\n \u221231.5 to \u22120.9],\n P<\/jats:italic>\n =0.038).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Preceding 60\u00a0months of\n CRI<\/jats:styled-content>\n is associated with increased risk of coronary calcification and altered\n OCN<\/jats:styled-content>\n expression in circulating\n EPCs<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011540","type":"journal-article","created":{"date-parts":[[2019,5,25]],"date-time":"2019-05-25T09:02:06Z","timestamp":1558774926000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cumulative Rheumatic Inflammation Modulates the Bone\u2013Vascular Axis and Risk of Coronary Calcification"],"prefix":"10.1161","volume":"8","author":[{"given":"Yap\u2010Hang","family":"Chan","sequence":"first","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Cheong","family":"Ngai","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"},{"name":"Cardiology Division Department of Medicine University of Hong Kong Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei\u2010Zhen","family":"Wu","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Juan","family":"Yu","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Zhen","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Lai","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommy","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lai\u2010Ming","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Hong Kong Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho\u2010Yin","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chak\u2010Sing","family":"Lau","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung\u2010Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"},{"name":"Cardiology Division Department of Medicine University of Hong Kong Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai\u2010Hang","family":"Yiu","sequence":"additional","affiliation":[{"name":"Cardiology Division Department of Medicine Queen Mary Hospital University of Hong Kong Hong Kong SAR China"},{"name":"Cardiology Division Department of Medicine University of Hong Kong 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