{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:43Z","timestamp":1789013323884,"version":"build-2803163510"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with rheumatoid arthritis (RA) are at increased risk of cardiovascular disease (CVD); however, effective risk stratification tools remain limited. The Endothelial Activation and Stress Index (EASIX) is a composite biomarker reflecting endothelial injury and cellular stress, but its association with CVD in populations with RA remains unexplored. This study aimed to investigate the association between EASIX and both CVD prevalence and CVD mortality in individuals with RA using a nationally representative sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Data were obtained from the National Health and Nutrition Examination Survey 2001 to 2018. Adults with RA and complete information on EASIX components and cardiovascular outcomes were included. EASIX was calculated as (lactate dehydrogenase\u00d7creatinine)\/platelet count. Logistic regression and Cox proportional hazards models were used to evaluate the associations between EASIX, CVD prevalence, and CVD mortality, adjusting for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 1857 participants with RA were included. Higher EASIX scores were significantly associated with increased odds of CVD prevalence and an elevated risk of CVD mortality. Notably, a nonlinear association was observed between EASIX and CVD mortality, indicating a threshold effect. These associations remained robust after controlling for systemic inflammation and other potential confounders. The robustness of our results was further supported by subgroup and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is the first study to demonstrate a significant association between EASIX and both CVD prevalence and mortality in individuals with RA. The findings highlight EASIX as a promising, easily accessible biomarker for cardiovascular risk stratification in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045422","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:14:42Z","timestamp":1785496482000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the Endothelial Activation and Stress Index With Cardiovascular Disease Prevalence and Mortality in Individuals With Rheumatoid Arthritis: First Population\u2010Based Evidence From the National Health and Nutrition Examination Survey"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4423-9105","authenticated-orcid":false,"given":"Junwei","family":"Chen","sequence":"first","affiliation":[{"name":"Zhoukou Medical Science Research Center","place":["Zhoukou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhoukou Medical Science Research Center","place":["Zhoukou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1264-1027","authenticated-orcid":false,"given":"Jianbang","family":"Fang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7135-1639","authenticated-orcid":false,"given":"Chunyang","family":"Lou","sequence":"additional","affiliation":[{"name":"Zhoukou Medical Science Research Center","place":["Zhoukou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9372-4645","authenticated-orcid":false,"given":"Pengfei","family":"Shi","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","unstructured":"WHO . 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