Rheumatoid Arthritis Associated With Increased Risk for Heart Failure Hospitalization

Rheumatoid arthritis (RA) is associated with an increased risk for hospitalization because of heart failure, according to a cohort study published in the Journal of the American Heart Association. The results of the study add to a significant body of evidence that rheumatoid arthritis is a clinically relevant risk factor for heart failure.

The study included the entire Danish population aged >18 years. Participants were followed from January 1, 2008, until December 31, 2012, or until first hospitalization for heart failure, emigration, or death. Patients with a diagnosis of heart failure at baseline were excluded (n=56,644), making the total number of eligible participants 4,305,225. The researchers compared patients diagnosed with RA between 1978 and 2008 (n=24,343) with the control group (n=4,280,882).

Over the course of the study, the researchers identified 744 patients in the RA group with incident heart failure compared with 49,879 in the control group. The RA group had an overall incident rate of heart failure of 6.64 (95% CI, 6.18-7.13) per 1000 person-years compared with an incident rate of 2.43 (95% CI, 2.41-2.45) for the control group.

After the researchers adjusted results to control for age, sex, calendar year, comorbidity, concomitant medications, socioeconomic status, alcohol consumption, and smoking history, the incidence rate ratio for incident heart failure in patients with RA remained significant, at 1.30 (95% CI, 1.17-1.45).

“These findings add to the existing evidence of RA as a clinically relevant risk factor for [heart failure,] and studies of the value of more-vigilant screening of these patients for HF are warranted,” wrote the researchers.

Reference

Khalid U, Egeberg A, Ahlehoff O, et al. Incident heart failure in patients with rheumatoid arthritis: a nationwide cohort study. J Am Heart Assoc. 2018;7:e007227.