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Rheumatoid arthritis (RA) is associated with increased mortality, predominantly due to accelerated atherosclerosis.1 Traditional cardiovascular disease (CVD) risk factors cannot fully account for this increased propensity and it seems that the sustained inflammatory state of RA represents a crucial element for enhanced atherosclerotic risk.1 2 In fact, CVD mortality in RA appears to be predicted by the level of disease activity and severity of joint damage and extra-articular manifestations.2 3 Some immunological markers, such as rheumatoid factor or antinuclear antibodies, are more often encountered in RA with extra-articular manifestations.4 Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been shown to be highly specific for …
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Competing interests: None.