RHEUMATOID-FACTOR, CHRONIC ARTHRITIS AND MORTALITY

Objective-To investigate chronic arthritis and rheumatoid factor (RF) for their prediction of premature total and cardiovascular mortality. Methods-In 1978-80, a representative population sample of 8000 Finns a ged 30 or more was invited to participate in a comprehensive health ex amination; 90% complied. Arthritis was diagnosed on the basis of medic al history, symptoms, and physical examination. Serum RF was determine d by the sensitised sheep cell agglutination test. Results-By the end of 1992 1597 of the subjects had died from all causes, including 876 d eaths from cardiovascular diseases. When adjusted for age, gender and smoking, the relative risk of persons with RF positive arthritis dying from any cause was 1.61 (95% confidence interval (CI) 1.03 to 2.51); RF negative non-erosive arthritis was not associated with mortality (r elative risk 1.03; 95% CI 0.72 to 1.49). In the absence of arthritis, 'false positive' RF titres greater than or equal to 128 predicted card iovascular deaths with a relative risk of 1.74 (95% CI 1.06 to 2.86). Conclusion-Both RF positive arthritis and false positive RF reactions predict mortality, but through different disease patterns.