ArticleClinical and experimental medicine2026
Joint association of systemic inflammatory response index and thromboelastography maximum amplitude with the risk of early atherosclerosis in patients with rheumatoid arthritis.
Article in Clinical and experimental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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). In joint analyses, RA patients with both high SIRI and TEG-MA had a 10.06-fold higher risk than those with low levels of both (odds ratio [OR]: 10.06, 95% confidence interval [CI]: 3.75-25.90). SIRI and TEG-MA showed notable additive interaction in affecting atherosclerosis risk, with relative excess risk of interaction (RERI) at 4.03 (95% CI: 1.25-9.36), attributable proportion of interaction (API) at 0.42 (95% CI: 0.03-0.79), and synergy index (SI) at 1.73 (95% CI: 1.03-2.96). No significant multiplicative interaction was detected (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.
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