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Updated: May 12, 2026

Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography
Published on: October 6, 2023
Rheumatoid Arthritis and Coronary Artery Calcium Progression: A Case Cohort Analysis From ELSA-Brasil
Patrícia Fonseca Estrada1, Marcos R N Cavalcante1, Itamar de Souza Santos1
1Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil.
Objective:
To investigate the association between rheumatoid arthritis (RA) and coronary artery calcium (CAC) prevalence, incidence, and progression over four years in adults without prior cardiovascular disease.
Methods:
A case-cohort study within the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) included 585 participants (86 patients with RA, 499 controls). Longitudinal analyses were restricted to those with CAC reassessed at four years (58 patients with RA, 352 controls). CAC was quantified by computed tomography (Agatston method). Incidence was defined as new CAC among those with baseline zero CAC; progression used Berry criteria. Multivariable regression models were hierarchically adjusted. Nonparametric bootstrap estimated 95% confidence intervals (CIs) for progression.
Results:
Mean ± SD age was 51.5 ± 8.9 years; 55.5% were female. RA was not associated with CAC prevalence (odds ratio [OR] 1.34; 95% CI 0.69-2.55) or incidence (OR 0.83; 95% CI 0.05-3.08) after adjustment. Conversely, RA was associated with CAC progression after multivariable adjustment (Model 1 OR 3.11; 95% bootstrap CI 1.52-8.41; Model 2 OR 4.29; 95% bootstrap CI 1.98-14.65).
Conclusion:
In this cohort, RA was associated with CAC progression despite no association with prevalence or incidence. These findings suggest chronic inflammation may drive calcification progression through nontraditional pathways, supporting longitudinal cardiovascular monitoring in RA.
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