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The review also assesses associations between RA and the ankle-brachial pressure index (ABPI). Study quality was appraised using the Crowe Critical Appraisal Tool (CCAT) and evidence levels were analyzed using the ASPS Evidence Rating Scale. Findings indicate an overall positive relationship of RA with PAD and with ABPI, while concomitant impacts on HRQOL and FC did not meet evidence-analysis criteria, with further study required.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/rheumatology-international-systematic-review-of-associations-between-rheumatoid-arthritis-and-peripheral-arterial-disease/501828/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/rheumatology-international-systematic-review-of-associations-between-rheumatoid-arthritis-and-peripheral-arterial-disease/501828.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-10-03",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the main aim of the systematic review?","Question",{"text":113,"@type":114},"To investigate associations between rheumatoid arthritis (RA) and peripheral arterial disease (PAD), including RA with the ankle-brachial pressure index (ABPI), and to evaluate effects on HRQOL and functional capacity (FC).","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were study quality and evidence levels assessed?",{"text":118,"@type":114},"Individual studies were appraised using the Crowe Critical Appraisal Tool (CCAT), and evidence levels were analyzed with the American Society of Plastic Surgeons (ASPS) Evidence Rating Scale for prognostic/risk studies.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the review find about RA, PAD, and ABPI?",{"text":122,"@type":114},"It reported a positive association between RA and PAD at evidence grade “II,” and between RA and ABPI at evidence grade “I,” while effects of concomitant manifestations on HRQOL and FC did not qualify for evidence-level analysis.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},501828,1791144151,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41,"preview_page_count":4},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Rheumatology International (2023) 43:221–232 [https://doi.org/10.1007/s00296-022-05245-7](https://doi.org/10.1007/s00296-022-05245-7)  \nRhe IOtology  \nSystematic review of associations between concomitant rheumatoid arthritis and peripheral arterial disease, health‑related quality of life and functional capacity  \nTayser Zoubi1 · Hendry Gordon2  \nReceived: 29 August 2022 / Accepted: 9 November 2022 / Published online: 30 November 2022 © The Author(s) 2022  \nAbstract  \nPatients with rheumatoid arthritis (RA) are at an increased risk of cardiovascular disease and vascular morbidity. The association between peripheral arterial disease (PAD) and RA has not been previously investigated within the scope of a review. Conjoined disease manifestations may impact patient well-being, perpetuating increased mortality and quality of life deficits. To investigate the association between RA and PAD, along with RA and the ankle-brachial pressure index (ABPI), the impact of disease concomitance on health-related quality of life (HRQOL) and functional capacity (FC) was also investigated. Individual study appraisal was completed using the Crowe Critical Appraisal Tool (CCAT) . A level of evidence analysis was conducted using the American Society of Plastic Surgeons (ASPS) Evidence Rating Scale for Prognostic/Risk Studies. AMED®, CINAHL®, Health Source: Nursing/Academic Edition, MEDLINE®, AHFS®, Scopus, Web of Science, Cochrane Library and Google scholar. Ten studies produced a CCAT rating of ≥ 30 (75%) and were deemed high quality, while a single study demonstrated a score of 26 (65%) suggesting moderate quality. A grade “II” levels of evidence was awarded to positive association between RA and PAD. A gradation of “I” was awarded to the association between ABPI and RA. The impact of concomitant manifestations on HRQOL and FC did not qualify for a level of evidence analysis. The systematic inflammatory nature of RA likely contributes to the increased incidence of PAD within the population. Further investigations are required to ascertain the impact of conjoined disease manifestations on HRQOL and FC.  \nKeywords Arthritis · Rheumatism (MeSh) · Peripheral arterial disease (MeSh) · Quality of life (MeSh) · Health-related quality of life  \nIntroduction  \nRheumatoid arthritis (RA) is an autoimmune inflammatory disorder of the synovial tissue [1] . It is associated with increases in patient morbidity and mortality [2, 3] . RA affects 1% of the general population, with early intervention significantly mediating a favorable prognosis [4] . Ongoing medical innovations in biologic agents  \n* Hendry Gordon [Gordon.Hendry@gcu.ac.uk](Gordon.Hendry@gcu.ac.uk)  \nTayser Zoubi  \n[Tayserzoubi92@gmail.com](Tayserzoubi92@gmail.com)  \n1 College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia  \n2 School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, Scotland  \nand disease-modifying drugs (DMARDs) have facilitated improved clinical outcomes [5] . In recent decades, RA has been denoted as an independent cardiovascular disease (CVD) risk factor [5] . This risk is perpetuated by the use of steroid-derived medication in the management of acute RA exacerbations, atherosclerotic changes inherent to the systemic inflammatory nature of RA, and the prevalence of vascular morbidities, including peripheral arterial disease (PAD) [2] .  \nThe underlying atherosclerotic mechanisms responsible for CVD within RA have also been suggested to impact the incidence of PAD [6] . Despite reported decreases in CVD risk secondary to the implementation of DMARDs and biologics, their impact on symptomatic or asymptomatic PAD development in the RA population is unknown [7, 8] . PAD is often associated with medium-and large-sized blood vessels of the lower limb, commonly the infra-inguinal or aortoiliac arteries [9] . Diagnosis of PAD is established through the  \nankle-brachial systolic pressure index (ABP","cbCaiv1dPOnjjnz7","https://ap.wps.com/l/cbCaiv1dPOnjjnz7","pdf",566791,12,"English","# Abstract\n# Introduction\n## RA as a cardiovascular risk factor\n## PAD diagnosis and clinical manifestations\n## Impact of PAD on mortality and quality of life\n## Evidence gap and purpose of the review","[{\"question\":\"What is the main aim of the systematic review?\",\"answer\":\"To investigate associations between rheumatoid arthritis (RA) and peripheral arterial disease (PAD), including RA with the ankle-brachial pressure index (ABPI), and to evaluate effects on HRQOL and functional capacity (FC).\"},{\"question\":\"How were study quality and evidence levels assessed?\",\"answer\":\"Individual studies were appraised using the Crowe Critical Appraisal Tool (CCAT), and evidence levels were analyzed with the American Society of Plastic Surgeons (ASPS) Evidence Rating Scale for prognostic/risk studies.\"},{\"question\":\"What did the review find about RA, PAD, and ABPI?\",\"answer\":\"It reported a positive association between RA and PAD at evidence grade “II,” and between RA and ABPI at evidence grade “I,” while effects of concomitant manifestations on HRQOL and FC did not qualify for evidence-level analysis.\"}]","Rheumatology International - Systematic review of associations between rheumatoid arthritis and peripheral arterial disease | PDF",1791025297]