Cardiovascular Events in Early Rheumatoid Arthritis — Role of Tumor Necrosis Factor Inhibition
Bibliographic record
Abstract
Cardiovascular (CV) comorbidity is frequent among patients with rheumatoid arthritis (RA)1. This is most marked regarding coronary disease, with an often-observed doubled risk of acute myocardial infarction in patients with RA compared with the general population1. Although the pathogenic mechanisms behind the increased risk of CV events remain to be explained, associations with traditional CV risk factors, as well as factors related to RA disease activity and severity, have been shown2. With disease-related risk factors being of importance, the effect of traditional risk factors on CV risk is lower in RA versus the general population3. Further, in the light of active RA disease, interpretation of risk factors can be complex, as illustrated by the effect of inflammation on blood lipids, or the effects of smoking on development of both RA and CV disease2,4,5. The high degree of systemic inflammation in active RA disease is associated with premature and accelerated atherosclerosis, a process that underlies many CV events6. Several studies evaluating newly diagnosed patients with RA have shown a rapid increase in CV risk after disease debut7. Accumulated disease activity during the earliest stages of RA disease has been associated with risk of CV events, and reduction in disease activity during the first year with an improved prognosis8,9. It has been suggested that there is a “window of opportunity” soon after disease debut, where control of inflammation can modify the risk of CV comorbidity10. The importance of inflammatory control is further emphasized by the association of treatment with synthetic disease-modifying antirheumatic drugs (DMARD) with a reduced risk of CV disease in both established and early RA, as observed in several studies8, … Address correspondence to Dr. Ljung, Department of Rheumatology, Umeå University Hospital, S-901 85 Umeå, Sweden. E-mail: lotta.ljung{at}vll.se
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".