Abstract
OBJECTIVE--To investigate chronic arthritis and rheumatoid factor (RF) for their prediction of premature total and cardiovascular mortality. METHODS--In 1978-80, a representative population sample of 8000 Finns aged 30 or more was invited to participate in a comprehensive health examination; 90% complied. Arthritis was diagnosed on the basis of medical history, symptoms, and physical examination. Serum RF was determined by the sensitised sheep cell agglutination test. RESULTS--By the end of 1992 1597 of the subjects had died from all causes, including 876 deaths from cardiovascular diseases. When adjusted for age, gender and smoking, the relative risk of persons with RF positive arthritis dying from any cause was 1.61 (95% confidence interval (CI) 1.03 to 2.51); RF negative non-erosive arthritis was not associated with mortality (relative risk 1.03; 95% CI 0.72 to 1.49). In the absence of arthritis, 'false positive' RF titres > or = 128 predicted cardiovascular deaths with a relative risk of 1.74 (95% CI 1.06 to 2.86). CONCLUSION--Both RF positive arthritis and false positive RF reactions predict mortality, but through different disease patterns.
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- Accinni L., Dixon F. J. Degenerative vascular disease and myocardial infarction in mice with lupus-like syndrome. Am J Pathol. 1979 Aug;96(2):477–492. [PMC free article] [PubMed] [Google Scholar]
- Aho K. Autoantibodies and the risk of death. Med Biol. 1980 Feb;58(1):8–13. [PubMed] [Google Scholar]
- Aho K., Heliövaara M., Maatela J., Tuomi T., Palosuo T. Rheumatoid factors antedating clinical rheumatoid arthritis. J Rheumatol. 1991 Sep;18(9):1282–1284. [PubMed] [Google Scholar]
- Aho K., Heliövaara M., Sievers K., Maatela J., Isomäki H. Clinical arthritis associated with positive radiological and serological findings in Finnish adults. Rheumatol Int. 1989;9(1):7–11. doi: 10.1007/BF00270283. [DOI] [PubMed] [Google Scholar]
- Aho K., Kurki P. Seropositive versus seronegative rheumatoid arthritis--time for a new definition. J Rheumatol. 1994 Mar;21(3):388–390. [PubMed] [Google Scholar]
- Aho K., Salonen J. T., Puska P. Autoantibodies predicting death due to cardiovascular disease. Cardiology. 1982;69(3):125–129. doi: 10.1159/000173494. [DOI] [PubMed] [Google Scholar]
- Allebeck P., Ahlbom A., Allander E. Increased mortality among persons with rheumatoid arthritis, but where RA does not appear on death certificate. Eleven-year follow-up of an epidemiological study. Scand J Rheumatol. 1981;10(4):301–306. doi: 10.3109/03009748109095320. [DOI] [PubMed] [Google Scholar]
- COBB S., ANDERSON F., BAUER W. Length of life and cause of death in rheumatoid arthritis. N Engl J Med. 1953 Oct 1;249(14):553–556. doi: 10.1056/NEJM195310012491402. [DOI] [PubMed] [Google Scholar]
- Heliövaara M., Aho K., Aromaa A., Knekt P., Reunanen A. Smoking and risk of rheumatoid arthritis. J Rheumatol. 1993 Nov;20(11):1830–1835. [PubMed] [Google Scholar]
- Heliövaara M., Aromaa A., Klaukka T., Knekt P., Joukamaa M., Impivaara O. Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey. J Clin Epidemiol. 1993 Feb;46(2):181–191. doi: 10.1016/0895-4356(93)90056-7. [DOI] [PubMed] [Google Scholar]
- Isomäki H., Kaarela K. Contrast between epidemiological and clinical concepts of rheumatoid arthritis. Scand J Rheumatol Suppl. 1988;74:29–32. doi: 10.3109/03009748809102936. [DOI] [PubMed] [Google Scholar]
- Jacobsson L. T., Knowler W. C., Pillemer S., Hanson R. L., Pettitt D. J., Nelson R. G., del Puente A., McCance D. R., Charles M. A., Bennett P. H. Rheumatoid arthritis and mortality. A longitudinal study in Pima Indians. Arthritis Rheum. 1993 Aug;36(8):1045–1053. doi: 10.1002/art.1780360804. [DOI] [PubMed] [Google Scholar]
- Larsen A., Dale K., Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. doi: 10.1177/028418517701800415. [DOI] [PubMed] [Google Scholar]
- Linos A., Worthington J. W., O'Fallon W. M., Kurland L. T. The epidemiology of rheumatoid arthritis in Rochester, Minnesota: a study of incidence, prevalence, and mortality. Am J Epidemiol. 1980 Jan;111(1):87–98. doi: 10.1093/oxfordjournals.aje.a112878. [DOI] [PubMed] [Google Scholar]
- Mathews J. D., Whittingham S., Hooper B. M., Mackay I. R., Stenhouse N. S. Association of autoantibodies with smoking, cardiovascular morbidity, and death in the Busselton population. Lancet. 1973 Oct 6;2(7832):754–758. doi: 10.1016/s0140-6736(73)91037-4. [DOI] [PubMed] [Google Scholar]
- Minick C. R. Immunologic arterial injury in atherogenesis. Ann N Y Acad Sci. 1976;275:210–227. doi: 10.1111/j.1749-6632.1976.tb43355.x. [DOI] [PubMed] [Google Scholar]
- Pincus T., Callahan L. F. The 'side effects' of rheumatoid arthritis: joint destruction, disability and early mortality. Br J Rheumatol. 1993 Mar;32 (Suppl 1):28–37. [PubMed] [Google Scholar]
- Poston R. N., Davies D. F. Immunity and inflammation in the pathogenesis of atherosclerosis. A review. Atherosclerosis. 1974 May-Jun;19(3):353–367. doi: 10.1016/s0021-9150(74)80001-8. [DOI] [PubMed] [Google Scholar]
- Puurunen M., Mänttäri M., Manninen V., Tenkanen L., Alfthan G., Ehnholm C., Vaarala O., Aho K., Palosuo T. Antibody against oxidized low-density lipoprotein predicting myocardial infarction. Arch Intern Med. 1994 Nov 28;154(22):2605–2609. [PubMed] [Google Scholar]
- Symmons D. P. Mortality in rheumatoid arthritis. Br J Rheumatol. 1988;27 (Suppl 1):44–54. [PubMed] [Google Scholar]
- Tuomi T., Heliövaara M., Palosuo T., Aho K. Smoking, lung function, and rheumatoid factors. Ann Rheum Dis. 1990 Oct;49(10):753–756. doi: 10.1136/ard.49.10.753. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wolfe F., Mitchell D. M., Sibley J. T., Fries J. F., Bloch D. A., Williams C. A., Spitz P. W., Haga M., Kleinheksel S. M., Cathey M. A. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994 Apr;37(4):481–494. doi: 10.1002/art.1780370408. [DOI] [PubMed] [Google Scholar]