RT Journal Article
SR Electronic
T1 The Influence of Rheumatoid Arthritis Disease Characteristics on Heart Failure
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1601
OP 1606
DO 10.3899/jrheum.100979
VO 38
IS 8
A1 ELENA MYASOEDOVA
A1 CYNTHIA S. CROWSON
A1 PAULO J. NICOLA
A1 HILAL MARADIT-KREMERS
A1 JOHN M. DAVIS III
A1 VÉRONIQUE L. ROGER
A1 TERRY M. THERNEAU
A1 SHERINE E. GABRIEL
YR 2011
UL http://www.jrheum.org/content/38/8/1601.abstract
AB Objective. To examine the influence of rheumatoid arthritis (RA) characteristics and antirheumatic medications on the risk of heart failure (HF) in patients with RA. Methods. A population-based incidence cohort of RA patients aged ≥ 18 years (1987 American College of Rheumatology criteria first met between January 1, 1980, and January 1, 2008) with no history of HF was followed until onset of HF (defined by Framingham criteria), death, or January 1, 2008. We collected data on RA characteristics, antirheumatic medications, and cardiovascular (CV) risk factors. Cox models adjusting for age, sex, and calendar year were used to analyze the data. Results. The study included 795 RA patients [mean age 55.3 yrs, 69% women, 66% rheumatoid factor (RF)-positive]. During the mean followup of 9.7 years, 92 patients developed HF. The risk of HF was associated with RF positivity (HR 1.6, 95% CI 1.0, 2.5), erythrocyte sedimentation rate (ESR) at RA incidence (HR 1.6, 95% CI 1.2, 2.0), repeatedly high ESR (HR 2.1, 95% CI 1.2, 3.5), severe extraarticular manifestations (HR 3.1, 95% CI 1.9, 5.1), and corticosteroid use (HR 2.0, 95% CI 1.3, 3.2), adjusting for CV risk factors and coronary heart disease (CHD). Methotrexate users were half as likely to have HF as nonusers (HR 0.5, 95% CI 0.3, 0.9). Conclusion. Several RA characteristics and the use of corticosteroids were associated with HF, with adjustment for CV risk factors and CHD. Methotrexate use appeared to be protective against HF. These findings suggest an independent effect of RA on HF that may be further modified by antirheumatic treatment.