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Research ArticleVasculitis

Long-term Risk of Heart Failure and Other Adverse Cardiovascular Outcomes in Granulomatosis With Polyangiitis: A Nationwide Cohort Study

Guoli Sun, Adelina Yafasova, Bo Baslund, Mikkel Faurschou, Morten Schou, Abdulrahman N. Shams-Eldin, Søren Lund Kristensen, Peter E. Weeke, Christian Torp-Pedersen, Emil L. Fosbøl, Lars Køber and Jawad H. Butt
The Journal of Rheumatology March 2022, 49 (3) 291-298; DOI: https://doi.org/10.3899/jrheum.210677
Guoli Sun
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Adelina Yafasova
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Bo Baslund
2B. Baslund, MD, PhD, M. Faurschou, MD, DMSc, Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Mikkel Faurschou
2B. Baslund, MD, PhD, M. Faurschou, MD, DMSc, Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Morten Schou
3M. Schou, MD, DMSc, Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen;
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Abdulrahman N. Shams-Eldin
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Søren Lund Kristensen
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Peter E. Weeke
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Christian Torp-Pedersen
4C. Torp-Pedersen, MD, DMSc, Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.
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Emil L. Fosbøl
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Lars Køber
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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Jawad H. Butt
1G. Sun, MD, A. Yafasova, MD, A.N. Shams-Eldin, MB, S.L. Kristensen, MD, PhD, P.E. Weeke, MD, PhD, E.L. Fosbøl, MD, PhD, L. Køber, MD, DMSc, J.H. Butt, MD, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen;
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  • For correspondence: jawad_butt91@hotmail.com
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Abstract

Objective To examine the long-term rates of heart failure (HF) and other adverse cardiovascular (CV) outcomes in a nationwide cohort of patients diagnosed with granulomatosis with polyangiitis (GPA) compared with the general population.

Methods Using Danish nationwide registries, patients with newly diagnosed GPA were identified and matched 1:4 by age, sex, and comorbidities with subjects from the general population. Outcomes were compared using Cox regression. Due to violation of the proportional hazard assumption, landmark analyses for the first year and from 1 year were performed.

Results Of the 1923 patients with GPA, 1781 patients (median age 59 yrs, 47.9% men) were matched with 7124 subjects from the general population. The median follow-up was 6.4 years. The absolute 10-year risk of HF was 6.8% (95% CI 5.5–8.2%) for patients with GPA and 5.9% (5.3–6.6%) for the general population. During the first year after diagnosis, GPA was associated with a significantly higher rate of HF (hazard ratio [HR] 3.60, 95% CI, 2.28–5.67) and other adverse outcomes, including atrial fibrillation/flutter (HR 6.50, 95% CI 4.43–9.55) and ischemic stroke (HR 3.24, 95% CI 1.92–5.48), compared with the general population. After the first year, GPA was not associated with higher rates of HF or other CV outcomes compared with the general population, except atrial fibrillation/flutter (HR 1.38, 95% CI 1.12-1.70).

Conclusion During the first year after diagnosis, the rates of HF and other CV outcomes were higher in patients with GPA compared with the general population. However, after the first year, the rates of HF and other CV outcomes, except atrial fibrillation/flutter, were similar to those in the general population.

Key Indexing Terms:
  • cardiovascular diseases
  • granulomatosis with polyangiitis
  • heart failure
  • Accepted for publication November 3, 2021.
  • Copyright © 2022 by the Journal of Rheumatology
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Long-term Risk of Heart Failure and Other Adverse Cardiovascular Outcomes in Granulomatosis With Polyangiitis: A Nationwide Cohort Study
Guoli Sun, Adelina Yafasova, Bo Baslund, Mikkel Faurschou, Morten Schou, Abdulrahman N. Shams-Eldin, Søren Lund Kristensen, Peter E. Weeke, Christian Torp-Pedersen, Emil L. Fosbøl, Lars Køber, Jawad H. Butt
The Journal of Rheumatology Mar 2022, 49 (3) 291-298; DOI: 10.3899/jrheum.210677

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Long-term Risk of Heart Failure and Other Adverse Cardiovascular Outcomes in Granulomatosis With Polyangiitis: A Nationwide Cohort Study
Guoli Sun, Adelina Yafasova, Bo Baslund, Mikkel Faurschou, Morten Schou, Abdulrahman N. Shams-Eldin, Søren Lund Kristensen, Peter E. Weeke, Christian Torp-Pedersen, Emil L. Fosbøl, Lars Køber, Jawad H. Butt
The Journal of Rheumatology Mar 2022, 49 (3) 291-298; DOI: 10.3899/jrheum.210677
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Keywords

CARDIOVASCULAR DISEASES
GRANULOMATOSIS WITH POLYANGIITIS
HEART FAILURE

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Keywords

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