Risk of heart failure elevated in RA patients
Heart failure (HF) that cannot be explained by an increased risk of ischaemic heart disease (IHD) is likely to occur among patients with rheumatoid arthritis (RA), according to a recent study. Additionally, this elevated risk of nonischaemic HF occurs early and is associated with RA severity.
Researchers identified two contemporary cohorts of RA participants from Swedish patient and rheumatology registries. These patients were matched 1:10 to general population comparator participants. Registry linkages were used to evaluate a first-ever HF diagnosis (classified as ischaemic or nonischaemic HF based on IHD presence).
Odds ratios were used to calculate relative risks for a history of HF before RA onset, and hazard ratios (HRs) for relative risks of incident HF in RA.
Prior HF was not associated with RA by the time of RA onset. The overall HRs for subsequent, ischaemic and nonischaemic HF in the new-onset RA cohort were between 1.22 and 1.27. There was a rapid increase in the risk of nonischaemic HF after RA onset contrary to the risk of ischaemic HF.
A correlation existed between high disease activity and all HF types, but it was most pronounced for nonischaemic HF. The HRs for the different HF subtypes in the cohort of patients with RA of any duration were between 1.71 and 1.88.
A previous study revealed that myocardial abnormalities were common in RA patients without known cardiac disease. There was an association between abnormal cardiac MRI and increased RA disease activity, which suggests a role for inflammation in the pathogenesis of myocardial involvement in RA. [Arthritis Res Ther 2010;12:R171]