Risk factors for cerebral infarction in patients with rheumatoid arthritis: a retrospective case-control study

To investigate the risk factors, including relevant autoantibodies, for cerebral infarction in patients with rheumatoid arthritis (RA).

Thirty-nine RA patients with cerebral infarction admitted to Weifang People's Hospital since January 2010 were selected as the RA cerebral infarction group. Seventy-two RA patients without cerebral infarction hospitalized during the same period were randomly selected as the RA non-cerebral infarction group. Gender, age, RA disease duration, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, anti-Sjögren's syndrome antigen A (anti-SSA) antibody, anti-Sjögren's syndrome antigen B (anti-SSB) antibody, Erythrocyte Sedimentation Rate(ESR), C-Reactive Protein(CRP), swollen joint count(SJC), tender joint count(TJC), patient global assessment(PGA), physician's global assessment (PhGA), as well as the presence of comorbid hypertension, diabetes, and smoking status were compared between the two groups. Additionally, Disease Activity Score-28 using ESR (DAS28-ESR), Disease Activity Score-28 using CRP(DAS28-CRP), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) were compared between the two groups.

Univariate analysis showed that there were statistically significant differences between the two groups in DAS28-ESR, DAS28-CRP, CRP levels, SJC, PGA, PhGA, SDAI, CDAI, anti-SSB positivity, and comorbid hypertension (P < 0.05), while no statistically significant differences were found in the remaining variables (P > 0.05). Multivariate logistic regression analysis revealed that anti-SSB positivity, SJC ≥ 11, and CRP ≥ 26.85 mg/l were independent risk factors for the occurrence of cerebral infarction in patients with rheumatoid arthritis. The most common clinical manifestation in the RA with cerebral infarction group was hemiplegia.

Positivity for anti-SSB antibody, SJC ≥ 11, and CRP ≥ 26.85 mg/l were independent risk factors for the occurrence of cerebral infarction in patients with rheumatoid arthritis.