Article Figures & Data
Tables
Characteristic Autoantibody RF ANA CCP No. subjects tested 6783 7852 299 No. positive (%) 703 (10.4) 1877 (23.9) 44 (14.7) Female, n (%) 4706 (69.4) 5408 (68.8) 212 (70.9) Age at first test (mean ± SD), yrs 49.7 ± 17.0 47.5 ± 17.0 54.5 ± 15.8 Length of followup (mean ± SD), yrs 9.4 ± 4.9 9.2 ± 5.0 2.5 ± 0.8 Patients who had rheumatic diseases (at time of testing or over time) Rheumatoid arthritis, n (%) 831 (12.2) 591 (7.5) 158 (52.8) Systemic lupus erythematosus, n (%) 114 (1.7) 159 (2.0) 15 (5.0) Polymyalgia rheumatica, n (%) 246 (3.6) 190 (2.4) 28 (9.4) Other connective tissue disease, n (%) 114 (1.7) 130 (1.7) 18 (6.0) Any of the above rheumatic diseases, n (%) 1147 (16.9) 943 (12.0) 182 (60.9) Patients who had rheumatic diseases (among those with positive tests) Any of the above rheumatic diseases, n (%) 456 (64.9) 431 (23.0) 42 (95.4) -
RF: rheumatoid factor; ANA: antinuclear antibody; CCP: cyclic citrullinated peptide antibody.
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Autoantibody Outcome Events Hazard Ratio (95% CI) Unadjusted for Presence of Rheumatic Disease* Adjusted for Presence of Rheumatic Disease* RF MI 365 1.36 (1.03, 1.79) 1.22 (0.91, 1.64) HF 499 1.47 (1.17, 1.84) 1.36 (1.07, 1.73) PVD 507 1.13 (0.88, 1.46) 1.08 (0.82, 1.43) MI, HF, or PVD** 871 1.32 (1.10, 1.59) 1.24 (1.01, 1.51) Death 998 1.55 (1.33, 1.80) 1.43 (1.21, 1.68) ANA MI 371 1.32 (1.06, 1.65) 1.29 (1.03, 1.61) HF 502 1.13 (0.93, 1.38) 1.11 (0.92, 1.35) PVD 522 1.37 (1.13, 1.66) 1.35 (1.12, 1.64) MI, HF, or PVD** 890 1.28 (1.10, 1.48) 1.26 (1.09, 1.46) Death 1142 1.19 (1.05, 1.35) 1.18 (1.04, 1.34) - Table 3.
Risk of “weak” versus “strong” autoantibody positivity on cardiovascular outcomes and death.
Autoantibody Outcome Hazard Ratio (95% CI) Unadjusted for Presence of Rheumatic Disease* Adjusted for Presence of Rheumatic Disease* Weak† RF MI, HF, or PVD** 0.93 (0.64, 1.36) 0.90 (0.61, 1.31) Death 1.04 (0.76, 1.43) 0.98 (0.71, 1.34) Strong† RF MI, HF, or PVD** 1.53 (1.24, 1.89) 1.42 (1.13, 1.79) Death 1.75 (1.48, 2.07) 1.62 (1.35, 1.93) Weak†† ANA MI, HF, or PVD** 1.24 (1.07, 1.44) 1.23 (1.06, 1.43) death 1.19 (1.04, 1.35) 1.17 (1.03, 1.33) Strong†† ANA MI, HF, or PVD** 1.90 (1.21, 2.98) 1.87 (1.19, 2.94) Death 1.34 (0.85, 2.13) 1.31 (0.82, 2.07) -
↵* Adjusted for age, sex, calendar year, comorbidity.
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↵** Defined as first occurrence of any of the 3 events.
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↵† Weak positive RF = 1:80 or 40–79 IU/ml; strong positive RF = 1:160 or ≥ 80 IU/ml; HR for weak and strong positive compared to normal RF.
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↵†† Weak positive ANA = 1:40 to 1:160 or 1–3 U; strong positive ANA = 1:320 or ≥ 3 U; HR for weak and strong positive compared to normal ANA. . RF: rheumatoid factor; ANA: antinuclear antibody; MI: myocardial infarction; HF: heart failure; PVD: peripheral vascular disease; comorbidity: chronic disease comorbidities9.
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- Table 4.
Risk of cardiovascular outcomes associated with autoantibodies in men versus women.
Autoantibody Outcome Events Hazard Ratio (95% CI)* Men Women Men Women RF MI, HF, or PVD** 313 558 1.46 (1.04, 2.04) 1.14 (0.88, 1.46) Death 382 616 1.31 (1.00, 1.71) 1.56 (1.27, 1.92) ANA MI, HF, or PVD** 310 580 1.40 (1.07, 1.82) 1.22 (1.02, 1.45) Death 475 667 1.17 (0.95, 1.44) 1.20 (1.02, 1.41) -
↵* Adjusted for age, calendar year, comorbidity, and presence of rheumatic disease.
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↵** Defined as first occurrence of any of the 3 events. RF: rheumatoid factor; ANA: antinuclear antibody; MI: myocardial infarction; HF: heart failure; PVD: peripheral vascular disease; comorbidity: chronic disease comorbidities9.
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- Table 5.
Characteristics of subjects with autoantibody testing vs control subjects without autoantibody testing.
Characteristic RF ANA Subjects with AutoAb Testing Subjects Without AutoAb Testing Subjects with AutoAb Testing Subjects Without AutoAb Testing No. 664 1259 772 1470 Female, n (%) 457 (68.8) 868 (68.9) 539 (69.8) 1032 (70.2) Age at first test/index (mean ± SD), yrs 50.0 ± 16.6 49.0 ± 16.5 47.8 ± 16.6 47.1 ± 16.6 Length of followup (mean ± SD), yrs 9.7 ± 4.7 9.6 ± 4.7 9.5 ± 4.7 9.5 ± 4.8 Chronic disease comorbidities at time of testing/index, n (%) Diabetes mellitus 46 (6.9) 70 (5.6) 45 (5.8) 70 (4.8) Liver disease 11 (1.7) 20 (1.6) 21 (2.7) 24 (1.6) Cerebrovascular disease 45 (6.8) 75 (6.0) 52 (6.7) 68 (4.6)* Chronic pulmonary disease 97 (14.6) 182 (14.5) 115 (14.9) 188 (12.8) Peptic ulcer 51 (7.7) 69 (5.5) 53 (6.9) 84 (5.7) Renal disease 17 (2.6) 35 (2.8) 22 (2.8) 31 (2.1) Malignancy 52 (7.8) 107 (8.5) 64 (8.3) 131 (8.9) Patients who had rheumatic diseases (at time of testing/index or over time) Rheumatoid arthritis, n (%) 80 (12.0) 40 (3.2)** 53 (6.9) 47 (3.2)** Systemic lupus erythematosus, n (%) 8 (1.2) 6 (0.5) 16 (2.1) 9 (0.6)** Polymyalgia rheumatica, n (%) 21 (3.2) 17 (1.4)** 20 (2.6) 24 (1.6) Other connective tissue disease, n (%) 12 (1.8) 3 (0.2)** 11 (1.4) 4 (0.3)** - Table 6.
Risk of cardiovascular outcomes in subjects with autoantibody testing vs matched control subjects without autoantibody testing.
Autoantibody Outcome Events Hazard Ratio (95% CI)* RF MI, HF, or PVD** 230 1.04 (0.78, 1.37) Death 264 0.95 (0.73, 1.24) ANA MI, HF, or PVD** 215 1.20 (0.93, 1.56) Death 218 0.93 (0.73, 1.19) -
↵* Adjusted for age, sex, calendar year, comorbidity, and presence of rheumatic disease.
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↵** Defined as first occurrence of any of the 3 events. RF: rheumatoid factor; ANA: antinuclear antibody; MI: myocardial infarction; HF: heart failure; PVD: peripheral vascular disease; HR: hazard ratio; comorbidity: chronic disease comorbidities9.
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