Triglyceride-glucose index combined with DAS28-ESR predicts cardiovascular disease risk in patients with rheumatoid arthritis: a national multicenter cohort study

Triglyceride-glucose index combined with DAS28-ESR predicts cardiovascular disease risk in patients with rheumatoid arthritis: a national multicenter cohort study. Download PDF Abstract Patients with rheumatoid arthritis (RA) face a significantly increased risk of cardiovascular disease (CVD). This study aimed to evaluate the combined association of systemic inflammatory activity and glucose-lipid metabolic abnormalities on long-term CVD outcomes in RA patients and to elucidate the dynamic trajectories of these factors during follow-up and their prognostic implications.

This prospective longitudinal cohort study included 4,902 RA patients without baseline CVD. Baseline and follow-up status matrices (G1–G4 groups) were constructed using the triglyceride-glucose (TyG) index and DAS28-ESR score. Multistage nested Cox proportional hazards regression models were employed to assess the adjusted association of combined status and dynamic trajectories on incident CVD.

Restricted cubic splines (RCS) quantified nonlinear associations, and the Delta method was used to estimate additive interaction measures. During a maximum 6-year follow-up, 355 incident CVD events occurred (7.24%). In the fully adjusted multifactorial model (Model 3), the baseline dual-high immune-metabolic status group (G4) showed significantly elevated incident CVD risk compared to the dual-low control group (G1) (HR 9.46, 95% CI 3.90–22.96, P < 0.001).

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