title: Progression of coronary artery atherosclerosis in rheumatoid arthritis: comparison with participants from the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  In cross-sectional studies, patients with rheumatoid arthritis (RA) have higher coronary artery calcium (CAC) than controls. However, their rate of progression of CAC and the predictors of CAC progression have heretofore remained unknown.
  
  
  METHODS
  Incidence and progression of CAC were compared in 155 patients with RA and 835 control participants. The association of demographic characteristics, traditional cardiovascular risk factors, RA disease characteristics and selected inflammatory markers with incidence and progression of CAC were evaluated.
  
  
  RESULTS
  The incidence rate of newly detected CAC was 8.2/100 person-years in RA and 7.3/100 person-years in non-RA control subjects [IRR 1.1 (0.7-1.8)]. RA patients who developed newly detectable CAC were older (59 ± 7 vs. 55 ± 6 years old, p=0.03), had higher triglyceride levels (137 ± 86 vs. 97 ± 60 mg/dL, p=0.03), and higher systolic blood pressure (129 ± 17 vs. 117 ± 15 mm Hg, p=0.01) compared to those who did not develop incident CAC. Differences in blood pressure and triglyceride levels remained significant after adjustment for age (p<=0.05). RA patients with any CAC at baseline had a median rate of yearly progression of 21 (7-62) compared to 21 (5-70) Agatston units in controls. No statistical differences between RA progressors and RA non-progressors were observed for inflammatory markers or for RA disease characteristics.
  
  
  CONCLUSIONS
  The incidence and progression of CAC did not differ between RA and non-RA participants. In patients with RA, incident CAC was associated with older age, higher triglyceride levels, and higher blood pressure, but not with inflammatory markers or RA disease characteristics.
authors.forename: Cecilia P
authors.initials: CP
authors.lastname: Chung
authors.forename: Jon T
authors.initials: JT
authors.lastname: Giles
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
authors.forename: Michelle
authors.initials: M
authors.lastname: Petri
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Robert
authors.initials: R
authors.lastname: Detrano
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.forename: David
authors.initials: D
authors.lastname: Bush
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bathon
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001213:Asian / Q000706:statistics & numerical data; D050197:Atherosclerosis / Q000150:complications / Q000208:ethnology / Q000473:pathology*; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000150:complications / Q000208:ethnology / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D014280:Triglycerides