{
  "abstract": "Background: Rheumatoid arthritis (RA) is associated with excess cardiovascular risk, but within-patient changes in complete blood count (CBC)-derived inflammatory indices at the onset of acute coronary syndrome (ACS) are not well described. We compared pre-event and acute-phase values in the same patients and contextualized pre-event values against a healthy cohort.\n\nMethods: This retrospective, single-center, within-patient paired study reviewed hospital records from July 1, 2018, to December 30, 2025 (approximately 90 months). Among 3,960 hospitalized patients with RA, 89 had clinician-confirmed ACS and qualifying paired CBC measurements. Acute-phase CBCs were obtained within 24 hours after symptom onset, and pre-event CBCs were the most recent routine measurements obtained more than 14 days before the event. The neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated and natural log-transformed. Pre-event values were also compared with a healthy cohort (n = 110), with age- and sex-adjusted analyses used because residual demographic imbalance was present.\n\nResults: Pre-event log(NLR), log(SII), and log(SIRI) were higher in the RA cohort than in healthy controls and remained higher after adjustment for age and sex (all P< 0.001). Within-patient analyses showed increases during ACS, with mean Δlog values of 0.466 for NLR, 0.508 for SII, and 0.381 for SIRI (all Benjamini–Hochberg-adjusted q< 0.001). Neutrophilia increased from 11.2% before the event to 41.6% during ACS (McNemar P< 0.001). Exploratory subgroup estimates were heterogeneous and non-monotonic across several small strata; changes did not differ materially between remission/low and moderate/high RA activity groups.\n\nConclusion: Among patients with RA who developed ACS, CBC-derived inflammatory indices were higher than in a healthy comparison cohort before the event and increased further within the first 24 hours of ACS. The paired design quantifies change relative to each patient’s own pre-event value. Without a non-RA ACS comparator, however, the study cannot establish RA-specific inflammatory priming or a causal chronic-to-acute mechanism. Prospective studies with serial sampling and clinical outcomes are needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency Internal Medicine, Weifang People’s Hospital , , ,",
    "Department of Rheumatology, Weifang People’s Hospital , ,",
    "Department of Rheumatology and Immunology, Peking University International Hospital , ,",
    "Dongfang Hospital, Beijing University of Chinese Medicine , ,",
    "Department of Rheumatology, Yidu Central Hospital of Weifang , , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yuwei Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuying Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Jing Zhang"
    },
    {
      "affs": [
        3
      ],
      "name": "Weiduo Nie"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaolong Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Fangcheng Su"
    },
    {
      "affs": [
        2
      ],
      "name": "Sheng-Guang Li"
    },
    {
      "affs": [
        4
      ],
      "name": "Yuanyuan Tang"
    },
    {
      "affs": [
        1
      ],
      "name": "Di Jin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5kyerndxwq3xw.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1833991",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662112/?tool=EBI",
  "id": "5kyerndxwq3xw",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13662112",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Inflammatory Biomarkers in Disease Prognosis"
    ]
  ],
  "openalex": "W7214972797",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662112/pdf/?tool=EBI",
  "pmcid": "PMC13662112",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5kyerndxwq3xw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:21Z",
      "native_id": "PMC:PMC13662112",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13662112"
    },
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1833991",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1833991/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Inflammatory Biomarkers in Disease Prognosis",
      "subfield": "oncology"
    }
  ],
  "title": "Dynamic changes in CBC-derived inflammatory indices before and during acute coronary syndrome in patients with rheumatoid arthritis: a within-patient paired study",
  "title_text": "Dynamic changes in CBC-derived inflammatory indices before and during acute coronary syndrome in patients with rheumatoid arthritis: a within-patient paired study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:15Z",
  "url": "https://research.draconitic.com/paper/5kyerndxwq3xw",
  "venue": "Frontiers in immunology",
  "versions": []
}