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SMR also were ascertained dependent on study DAS28 scores using the low disease activity (DAS http://www.selleckchem.com/products/lee011.html cause-specific SMR by early or established disease cohort are shown in Table?3. Cancer was the primary cause of death in 56 patients in the combined cohorts, SMR 1.28 (0.99, 1.66). An infective illness was listed as the primary cause of death in 24 patients, specifically septicaemia http://www.selleck.cn/products/AZD6244.html in18 patients. In only 16 patients was RA listed as primary cause of death. The primary cause of death was not specified in 11 study population patients. In patients whose year of death was listed since 1997, RA was listed as either the primary cause of death or contributing to cause of death in only 25 of 157 patients (16%). This is one of a few international studies that report the life years lost attributable to RA, and the first Australian study that reports the SMR in a well-defined cohort of patients with this disease. In this 14-year longitudinal observational study, compared with the general Australian population, patients with RA have a decreased life expectancy, with the median number of life years lost in the early RA, early 1990s disease cohort of 6 years for males and http://www.selleckchem.com/products/bmn-673.html 7 years for females, and in the pre-1990s disease cohort of 8 years for males and 10 years for females. We also found an increased SMR in patients with RA, although in the early 1990s cohort, the SMR for all-cause mortality of 1.31 was not statistically significant as the 95% CI included 1.0, and possibly a reflection of the smaller sample size of this cohort. In the pre-1990s cohort, the SMR was 1.73 and was statistically significant. Although the SMR in our pre-1990s cohort was greater than the early 1990s cohort, suggesting a secular reduction in excess mortality in RA, there was overlap of the respective CI. We found no significant gender difference for all-cause mortality and cause-specific mortality. The excess cardiovascular mortality in patients with RA is well reported,[8, 9] and there has been a secular shift regarding identification of risk factors and their management in this disease.