{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:55:28Z","timestamp":1790751328942,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) is associated with excess cardiovascular risk, but within-patient changes in complete blood count (CBC)-derived inflammatory indices at the onset of acute coronary syndrome (ACS) are not well described. We compared pre-event and acute-phase values in the same patients and contextualized pre-event values against a healthy cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single-center, within-patient paired study reviewed hospital records from July 1, 2018, to December 30, 2025 (approximately 90 months). Among 3,960 hospitalized patients with RA, 89 had clinician-confirmed ACS and qualifying paired CBC measurements. Acute-phase CBCs were obtained within 24 hours after symptom onset, and pre-event CBCs were the most recent routine measurements obtained more than 14 days before the event. The neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated and natural log-transformed. Pre-event values were also compared with a healthy cohort (n = 110), with age- and sex-adjusted analyses used because residual demographic imbalance was present.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pre-event log(NLR), log(SII), and log(SIRI) were higher in the RA cohort than in healthy controls and remained higher after adjustment for age and sex (all P&amp;lt; 0.001). Within-patient analyses showed increases during ACS, with mean \u0394log values of 0.466 for NLR, 0.508 for SII, and 0.381 for SIRI (all Benjamini\u2013Hochberg-adjusted q&amp;lt; 0.001). Neutrophilia increased from 11.2% before the event to 41.6% during ACS (McNemar P&amp;lt; 0.001). Exploratory subgroup estimates were heterogeneous and non-monotonic across several small strata; changes did not differ materially between remission\/low and moderate\/high RA activity groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with RA who developed ACS, CBC-derived inflammatory indices were higher than in a healthy comparison cohort before the event and increased further within the first 24 hours of ACS. The paired design quantifies change relative to each patient\u2019s own pre-event value. Without a non-RA ACS comparator, however, the study cannot establish RA-specific inflammatory priming or a causal chronic-to-acute mechanism. Prospective studies with serial sampling and clinical outcomes are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1833991","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:01:47Z","timestamp":1790748107000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic changes in CBC-derived inflammatory indices before and during acute coronary syndrome in patients with rheumatoid arthritis: a within-patient paired study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuwei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Emergency Internal Medicine, Weifang People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Weifang People\u2019s Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiduo","family":"Nie","sequence":"additional","affiliation":[{"name":"Dongfang Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency Internal Medicine, Weifang People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangcheng","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Emergency Internal Medicine, Weifang People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Guang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Yidu Central Hospital of Weifang","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Weifang People\u2019s Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1036","article-title":"Increased cardiovascular risk in rheumatoid arthritis: mechanisms 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