{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:17:43Z","timestamp":1787807863279,"version":"build-2784847793"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with rheumatoid arthritis (RA) face increased cardiovascular disease (CVD) risk not fully explained by traditional factors. Chronic cytomegalovirus (CMV) infection may contribute through immune activation and vascular inflammation. This pilot study investigated associations between CMV serostatus, vascular endothelial growth factor A (VEGF-A), and inflammatory markers in patients with RA and\/or CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study enrolled 76 participants (CVD = 40, RA = 18, RA+CVD = 18). Serum anti-CMV antibodies, VEGF-A, and IL-6 were measured by ELISA; CRP was assessed by agglutination; and CMV viral load was quantified by RT-PCR. Group comparisons analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CMV seroprevalence was 80.3% overall (CVD: 82.5%; RA: 77.8%; RA+CVD: 77.8%). VEGF-A levels were higher in CMV positive vs. CMV negative individuals, but the differences were not statistically significant; these data are inconclusive regarding a true association (e.g., overall mean: 67.8 vs. 44.5 pg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.12). No significant differences were found among clinical groups for CMV IgG positivity, viral load, IL-6, CRP, or VEGF-A (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt; 0.05 for all). However, viral load, IL 6 and CRP showed numerical increases that did not reach statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot study is underpowered for definitive conclusions and should be interpreted as exploratory and hypothesis-generating. Although VEGF-A levels were higher in CMV positive individuals, the association was not statistically significant and the data are inconclusive. Larger, adequately powered studies are needed to clarify the role of CMV and angiogenic pathways in RA associated CVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1926089","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:25:50Z","timestamp":1787804750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rheumatoid arthritis and cardiovascular disease in relation to cytomegalovirus infection: a pilot cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Mohammed Ahmed","family":"Al-Kaif","sequence":"first","affiliation":[{"name":"Department of Cardiology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University","place":["Qingpu, Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith A. I. K.","family":"Al-Kaif","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Hammurabi College of Medicine, University of Babylon","place":["Hillah, Babylon, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid Saad","family":"Madhi","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation and Physical Therapy, College of Health and Medical Techniques, Al-Mustaqbal University","place":["Hillah, Babylon, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalya Talal Fathi","family":"Al-Azzawi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Al-Iraqia University","place":["Baghdad, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael Rasheed Obaead","family":"Alfatlawi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, College of Medicine, University of Babylon","place":["Hillah, Babylon, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Kassab Shandaway","family":"Al-Zamali","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Hammurabi College of Medicine, University of Babylon","place":["Hillah, Babylon, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatin Alaa Abdul Ameer","family":"Mahdi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hammurabi College of Medicine, University of Babylon","place":["Hillah, Babylon, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University","place":["Qingpu, Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1136\/annrheumdis-2011-200726","article-title":"Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies","volume":"71","author":"Avina-Zubieta","year":"2012","journal-title":"Ann Rheum Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1002\/art.24836","article-title":"Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? 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