Heart Failure Risk in Patients With Systemic Autoimmune Inflammatory Diseases

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Background:

• Systemic autoimmune inflammatory diseases (SAIDs) significantly increase morbidity and mortality due to cardiac disease, particularly heart failure (HF).
• Understanding HF risk in SAID patients and the impact of cardiovascular medications is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the risk of incident heart failure (HF) in patients with various systemic autoimmune inflammatory diseases (SAIDs).
• To investigate the association between the use of cardiovascular drugs and the occurrence of incident HF among SAID patients.

Main Methods:

• A retrospective cohort study analyzed electronic health records of 182,795 adult patients with SAIDs (including systemic sclerosis, lupus, rheumatoid arthritis, psoriatic arthritis, inflammatory bowel disease, and HIV) from 2000 to 2020.
• Incident HF risk was tracked within a large healthcare system, comparing SAID patients to controls and analyzing medication effects.

Main Results:

• Systemic sclerosis, systemic lupus erythematosus, and rheumatoid arthritis were significantly associated with increased incident HF risk compared to controls and inflammatory bowel disease patients.
• Beta-blocker use at baseline demonstrated an association with decreased incident HF in patients with systemic sclerosis, lupus, and rheumatoid arthritis.

Conclusions:

• Patients with systemic sclerosis, lupus, and rheumatoid arthritis exhibit an elevated HF risk, suggesting an autoimmune mechanism contributing to cardiac involvement.
• Beta-blocker use appears to have a cardioprotective effect, potentially reducing HF incidence in patients with SAIDs.