The effect of rheumatoid factor on mortality | Arthritis Information

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Ann Rheum Dis. Published Online First: 23 July 2009. doi:10.1136/ard.2009.110536
Copyright © 2009 BMJ Publishing Group Ltd & European League Against Rheumatism.

The effect of rheumatoid factor on mortality and coronary heart disease

Gunnar Tomasson 1*, Thor Aspelund 2, Thorbjorn Jonsson 3, Helgi Valdimarsson 3, David T Felson 1 and Vilmundur Gudnason 2

1 Boston University, United States
2 Icelandic Heart Association, Iceland
3 Landspitali University Hospital, Iceland

* To whom correspondence should be addressed. E-mail: gunnar.tomasson@gmail.com ' + u + '@' + d + ''//--> .

Accepted 27 June 2009


Abstract

Objective: In persons with rheumatoid arthritis, studies have described an association of rheumatoid factor (RF) with increased mortality. Our objective was to determine the effect of RF on mortality and coronary heart disease (CHD) in the general population.

Methods: Subjects were participants in a population-based study focused on cardiovascular disease who came for study visit during the years 1974-1984. RF was measured and information obtained on cardiovascular risk factors, joint symptoms and erythrocyte sedimentation rate (ESR). Subjects were followed with respect to mortality and incident CHD through 2005. Adjusted comparison of overall survival and CHD-event free survival among the RF-positive vs. RF-negative subjects was performed with Cox proportional hazards regression models.

Results: Of 11,872 subjects, 140 had positive RF. At baseline, RF was associated with diabetes mellitus and smoking and inversely associated with serum cholesterol. RF-positive subjects had increased all-cause mortality (HR=1.47, 95% CI: 1.19-1.80) and cardiovascular mortality (HR=1.57, 95% CI: 1.15-2.14) after adjusting for age and sex. Further adjustment for cardiovascular risk factors and ESR only modestly attenuated this effect. Increase in CHD among the RF-positive subjects did not reach statistical significance. (HR=1.32, 95% CI: 0.96-1.81) adjusted for age and sex. Subjects with RF but without joint symptoms also had increased overall mortality and cardiovascular mortality (after adjustment, HR for overall mortality =1.33, 95% CI 1.01-1.74).

Conclusion: In a general population cohort, RF was associated with increased all-cause mortality and cardiovascular mortality after adjustment for cardiovascular risk factors, even among subjects without joint symptoms.

http://ard.bmj.com/cgi/content/short/ard.2009.110536v1?rss=1

Hmmmm.  I wonder what this means for people whos RF goes back and forth between pos and neg. 

i would say that puts you in the in between stage....not at as much risk as a solidly sero positive person but at a greater risk than a solidly sero negative person

I wonder what percentage of sero-negative RA people are non-smokers, and what % of sero-positive are current or past smokers?  They say smoking increases RF, and the article states that RF was associated with smoking...... could the smoking factor alone increase chances of CHD in RA patients? 

I debunk that myth!  I am sero-negative and I smoked for 30 years (minus 6 years of pregnancy.) I'm the opposite...very sero positive and a lifetime non somoker BUT I was heavily exposed to second hand smoke throughout my childhood so that may be a factorI've got a mildly positive RF Factor (33) and have never smoked or lived with anyone who did smoke. 

I've been fortunate to have never  smoked or lived with a smoker or even had a visitor smoke in my home. I've never even had an ashtray, even in my childhood home.

My RF, checked every 6-12mo, varies between 1,250-1,670 from no other cause but RA.  The high result does not correlate with severity of symptoms, in fact it's in that range whether I'm having a flare or not.
I wonder if a high RF number makes a difference.

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