Risk of heart failure up for rheumatoid arthritis patients
Ängla Mantel, M.D., from the Karolinska Institutet in Stockholm, and colleagues identified two contemporary cohorts of RA subjects from Swedish patient and rheumatology registries and matched them 1:10 to comparator subjects from the general population. The authors assessed first-ever heart failure diagnosis through registry linkages.
The researchers found that a history of heart failure was not more common in RA by the time of RA onset. The overall hazard ratios for subsequent heart failure (any type), ischemic heart failure, and non-ischemic heart failure were between 1.22 and 1.27 among new-onset RA patients. There was a rapid increase in the risk of non-ischemic heart failure after onset of RA, in contrast to the risk of ischemic heart failure. There were correlations for high disease activity with all heart failure types, with the most pronounced correlation for non-ischemic heart failure. For the different heart failure subtypes, the hazard ratios were between 1.71 and 1.88 in the cohort of patients with RA of any duration.
"Patients with RA are at increased risk of heart failure that cannot be explained by their increased risk of ischemic heart disease," the authors write. "The increased risk of non-ischemic heart failure occurred early and was associated with RA severity."
One author disclosed financial ties to the pharmaceutical industry.
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