Systemic inflammation and hypercoagulability are two major characteristics of rheumatoid arthritis (RA), both contributing to atherosclerosis development. This study aims to evaluate their joint and mutual associations with early atherosclerosis risk in RA patients via the systemic inflammation response index (SIRI) and thromboelastography maximum amplitude (TEG-MA). The study encompassed 335 RA patients who fulfilled the specified inclusion criteria. Logistic regression assessed SIRI, TEG-MA, and their combined link to early atherosclerosis risk. Both multiplicative and additive interactions were evaluated, and a bidirectional mediation model explored their reciprocal impacts on early atherosclerosis. After full confounder adjustment, SIRI and TEG-MA both showed significant positive links to early atherosclerosis risk, whether analyzed as continuous or categorical variables (P 0.05). Mutual mediation analysis showed SIRI mediated 40.6% of TEG-MA's effect, while TEG-MA mediated 27.6% of SIRI's effect on atherosclerosis risk. These results suggest that there is an intertwined and mutually reinforcing relationship between inflammation and hypercoagulability in the occurrence and progression of atherosclerosis in RA.
Zhang et al. (Sun,) studied this question.