Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality

E. Blair Solow, Fang Yu, Geoffrey M. Thiele, Jeremy Sokolove, William H. Robinson, Zachary M. Pruhs, Kaleb D. Michaud, Alan R. Erickson, Harlan Sayles, Gail S. Kerr, Angelo L. Gaffo, Liron Caplan, Lisa A. Davis, Grant W. Cannon, Andreas M. Reimold, Joshua Baker, Pascale Schwab, Daniel R. Anderson, Ted R. Mikuls

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To examine whether vascular calcifications on hand films in RA might aid in determining mortality risk.

CONCLUSION: Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. Mechanisms underpinning the associations of IL-4 and select ACPA with vascular calcifications and their utility as biomarkers predictive of cardiovascular disease risk in RA merit further study.

METHODS: Hand radiographs from 906 RA patients were scored as positive or negative for vascular calcifications. Patient characteristics associated with vascular calcifications were assessed using multivariable logistic regression, and associations with mortality were examined using Cox proportional hazards regression. Cytokines and multiplex ACPA were measured in both groups.

RESULTS: A total of 99 patients (11%) demonstrated radiographic vascular calcifications. Factors independently associated with vascular calcifications included diabetes [odds ratio (OR) 2.85; 95% CI 1.43, 5.66], cardiovascular disease at enrolment (OR 2.48; 95% CI 1.01, 6.09), prednisone use (OR 1.90; 95% CI 1.25, 2.91), current smoking (OR 0.06; 95% CI 0.01, 0.23) and former smoking (OR 0.36; 95% CI 0.27, 0.48) vs never smoking. In cytokine and ACPA subtype analysis, IL-4 and anti-citrullinated apolipoprotein E were significantly increased in patients with vascular calcifications in fully adjusted multivariable models. After multivariable adjustment, vascular calcifications were associated with an increase in all-cause mortality (hazard ratio 1.41; 95% CI 1.12, 1.78; P = 0.004).

Original languageEnglish (US)
Pages (from-to)1587-1595
Number of pages9
JournalRheumatology (Oxford, England)
Volume54
Issue number9
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Fingerprint

Vascular Calcification
Autoantibodies
Rheumatoid Arthritis
Hand
Mortality
Odds Ratio
Smoking
Interleukin-4
Cardiovascular Diseases
Cytokines
Social Adjustment
Apolipoproteins E
Motion Pictures
Prednisone
Biomarkers
Logistic Models

Keywords

  • anti-citrullinated protein autoantibodies
  • hand radiographs
  • mortality
  • rheumatoid arthritis
  • vascular calcifications

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality. / Blair Solow, E.; Yu, Fang; Thiele, Geoffrey M.; Sokolove, Jeremy; Robinson, William H.; Pruhs, Zachary M.; Michaud, Kaleb D.; Erickson, Alan R.; Sayles, Harlan; Kerr, Gail S.; Gaffo, Angelo L.; Caplan, Liron; Davis, Lisa A.; Cannon, Grant W.; Reimold, Andreas M.; Baker, Joshua; Schwab, Pascale; Anderson, Daniel R.; Mikuls, Ted R.

In: Rheumatology (Oxford, England), Vol. 54, No. 9, 01.09.2015, p. 1587-1595.

Research output: Contribution to journalArticle

Blair Solow, E, Yu, F, Thiele, GM, Sokolove, J, Robinson, WH, Pruhs, ZM, Michaud, KD, Erickson, AR, Sayles, H, Kerr, GS, Gaffo, AL, Caplan, L, Davis, LA, Cannon, GW, Reimold, AM, Baker, J, Schwab, P, Anderson, DR & Mikuls, TR 2015, 'Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality', Rheumatology (Oxford, England), vol. 54, no. 9, pp. 1587-1595. https://doi.org/10.1093/rheumatology/kev027
Blair Solow, E. ; Yu, Fang ; Thiele, Geoffrey M. ; Sokolove, Jeremy ; Robinson, William H. ; Pruhs, Zachary M. ; Michaud, Kaleb D. ; Erickson, Alan R. ; Sayles, Harlan ; Kerr, Gail S. ; Gaffo, Angelo L. ; Caplan, Liron ; Davis, Lisa A. ; Cannon, Grant W. ; Reimold, Andreas M. ; Baker, Joshua ; Schwab, Pascale ; Anderson, Daniel R. ; Mikuls, Ted R. / Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality. In: Rheumatology (Oxford, England). 2015 ; Vol. 54, No. 9. pp. 1587-1595.
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abstract = "OBJECTIVE: To examine whether vascular calcifications on hand films in RA might aid in determining mortality risk.CONCLUSION: Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. Mechanisms underpinning the associations of IL-4 and select ACPA with vascular calcifications and their utility as biomarkers predictive of cardiovascular disease risk in RA merit further study.METHODS: Hand radiographs from 906 RA patients were scored as positive or negative for vascular calcifications. Patient characteristics associated with vascular calcifications were assessed using multivariable logistic regression, and associations with mortality were examined using Cox proportional hazards regression. Cytokines and multiplex ACPA were measured in both groups.RESULTS: A total of 99 patients (11{\%}) demonstrated radiographic vascular calcifications. Factors independently associated with vascular calcifications included diabetes [odds ratio (OR) 2.85; 95{\%} CI 1.43, 5.66], cardiovascular disease at enrolment (OR 2.48; 95{\%} CI 1.01, 6.09), prednisone use (OR 1.90; 95{\%} CI 1.25, 2.91), current smoking (OR 0.06; 95{\%} CI 0.01, 0.23) and former smoking (OR 0.36; 95{\%} CI 0.27, 0.48) vs never smoking. In cytokine and ACPA subtype analysis, IL-4 and anti-citrullinated apolipoprotein E were significantly increased in patients with vascular calcifications in fully adjusted multivariable models. After multivariable adjustment, vascular calcifications were associated with an increase in all-cause mortality (hazard ratio 1.41; 95{\%} CI 1.12, 1.78; P = 0.004).",
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T1 - Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality

AU - Blair Solow, E.

AU - Yu, Fang

AU - Thiele, Geoffrey M.

AU - Sokolove, Jeremy

AU - Robinson, William H.

AU - Pruhs, Zachary M.

AU - Michaud, Kaleb D.

AU - Erickson, Alan R.

AU - Sayles, Harlan

AU - Kerr, Gail S.

AU - Gaffo, Angelo L.

AU - Caplan, Liron

AU - Davis, Lisa A.

AU - Cannon, Grant W.

AU - Reimold, Andreas M.

AU - Baker, Joshua

AU - Schwab, Pascale

AU - Anderson, Daniel R.

AU - Mikuls, Ted R.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - OBJECTIVE: To examine whether vascular calcifications on hand films in RA might aid in determining mortality risk.CONCLUSION: Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. Mechanisms underpinning the associations of IL-4 and select ACPA with vascular calcifications and their utility as biomarkers predictive of cardiovascular disease risk in RA merit further study.METHODS: Hand radiographs from 906 RA patients were scored as positive or negative for vascular calcifications. Patient characteristics associated with vascular calcifications were assessed using multivariable logistic regression, and associations with mortality were examined using Cox proportional hazards regression. Cytokines and multiplex ACPA were measured in both groups.RESULTS: A total of 99 patients (11%) demonstrated radiographic vascular calcifications. Factors independently associated with vascular calcifications included diabetes [odds ratio (OR) 2.85; 95% CI 1.43, 5.66], cardiovascular disease at enrolment (OR 2.48; 95% CI 1.01, 6.09), prednisone use (OR 1.90; 95% CI 1.25, 2.91), current smoking (OR 0.06; 95% CI 0.01, 0.23) and former smoking (OR 0.36; 95% CI 0.27, 0.48) vs never smoking. In cytokine and ACPA subtype analysis, IL-4 and anti-citrullinated apolipoprotein E were significantly increased in patients with vascular calcifications in fully adjusted multivariable models. After multivariable adjustment, vascular calcifications were associated with an increase in all-cause mortality (hazard ratio 1.41; 95% CI 1.12, 1.78; P = 0.004).

AB - OBJECTIVE: To examine whether vascular calcifications on hand films in RA might aid in determining mortality risk.CONCLUSION: Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. Mechanisms underpinning the associations of IL-4 and select ACPA with vascular calcifications and their utility as biomarkers predictive of cardiovascular disease risk in RA merit further study.METHODS: Hand radiographs from 906 RA patients were scored as positive or negative for vascular calcifications. Patient characteristics associated with vascular calcifications were assessed using multivariable logistic regression, and associations with mortality were examined using Cox proportional hazards regression. Cytokines and multiplex ACPA were measured in both groups.RESULTS: A total of 99 patients (11%) demonstrated radiographic vascular calcifications. Factors independently associated with vascular calcifications included diabetes [odds ratio (OR) 2.85; 95% CI 1.43, 5.66], cardiovascular disease at enrolment (OR 2.48; 95% CI 1.01, 6.09), prednisone use (OR 1.90; 95% CI 1.25, 2.91), current smoking (OR 0.06; 95% CI 0.01, 0.23) and former smoking (OR 0.36; 95% CI 0.27, 0.48) vs never smoking. In cytokine and ACPA subtype analysis, IL-4 and anti-citrullinated apolipoprotein E were significantly increased in patients with vascular calcifications in fully adjusted multivariable models. After multivariable adjustment, vascular calcifications were associated with an increase in all-cause mortality (hazard ratio 1.41; 95% CI 1.12, 1.78; P = 0.004).

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