WEDNESDAY, March 4, 2020 (HealthDay News) — Among patients with rheumatoid arthritis (RA), a serum folate level of at least 4.3 ng/mL is associated with lower cardiovascular (CV) mortality risk, according to a study published online Feb. 26 in JAMA Network Open.

Kalyani Sonawane, Ph.D., from the University of Texas Health Science Center at Houston, and colleagues examined the association of serum folate concentration and CV mortality risk among patients with RA using data from the U.S. National Health and Nutrition Examination Survey (1988 to 1994) and the 2011 Linked Mortality File. The analysis included 683 patients with RA (mean age, 55.9 years; 30.2 percent men) who were classified into tertiles based on serum folate levels (tertile 1, folate levels <4.3 ng/mL [239 patients]; tertile 2, folate levels 4.3 to 8.2 ng/mL [234 patients]; and tertile 3, folate levels >8.2 ng/mL [210 patients]).

The researchers found that during a median (interquartile range) follow-up of 17.4 years, there were 392 all-cause deaths and 258 CV deaths. Patients in tertile 2 had lower all-cause mortality risk (hazard ratio [HR], 0.63) compared with tertile 1. Similarly, the risk for CV mortality was lower among patients in tertile 2 (HR, 0.52) and tertile 3 (HR, 0.44) compared with those in tertile 1. Patients in tertile 2 (HR, 0.31) and tertile 3 (HR, 0.39) had lower CV mortality risk compared with those in tertile 1 in an analysis that estimated 10-year risk.

“If a causal link is validated in future clinical studies, folate supplementation can be an inexpensive strategy for reducing CV mortality risk in patients with RA,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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